Percutaneous aspiration thromboembolectomy: a preliminary experience

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Cardiovascular Medicine

Background:

• Acute arterial thromboembolic disease requires timely intervention.
• Traditional treatments include surgical embolectomy and thrombolysis.
• Percutaneous aspiration thromboembolectomy (PAT) presents a radiological alternative.

Purpose of the Study:

• To report the clinical experience with PAT in patients with acute arterial thromboembolic disease.
• To evaluate the efficacy and safety of PAT as a primary treatment or adjunct therapy.
• To compare PAT outcomes with established treatment modalities.

Main Methods:

• Retrospective analysis of eight patients (aged 63-83 years) undergoing PAT.
• PAT performed on various arterial sites including iliac, femoral, and popliteal arteries.
• Indications included graft thrombosis, emboli from atrial fibrillation, abdominal aneurysm, and angioplasty complications.
• PAT used as sole procedure or adjunct to thrombolysis/angioplasty.

Main Results:

• Successful PAT in six patients (seven arterial sites), with a significant increase in mean Ankle-Brachial Index (ABI) from 0.4 to 0.8.
• Two failures led to amputations, one involving a thrombosed graft and another a prior failed surgical embolectomy.
• No major complications or mortality observed during the 1-month follow-up period.

Conclusions:

• PAT is an effective radiological treatment for acute arterial thromboembolic disease.
• It serves as a useful adjunct to thrombolysis and angioplasty.
• PAT provides a viable alternative to surgical embolectomy, especially when thrombolysis is contraindicated.