Observation of the effect of angiojet to treat acute lower extremity arterial embolization

Xiao-Hu Meng; Xu-Pin Xie; Yong-Chang Liu; Chang-Pin Huang; Lin-Jun Wang; Han-Yi Liu; Xin Fang; Guo-Hui Zhang

doi:10.12998/wjcc.v11.i15.3491

Observation of the effect of angiojet to treat acute lower extremity arterial embolization

World J Clin Cases. 2023 May 26;11(15):3491-3501. doi: 10.12998/wjcc.v11.i15.3491.

Authors

Xiao-Hu Meng¹, Xu-Pin Xie¹, Yong-Chang Liu¹, Chang-Pin Huang², Lin-Jun Wang¹, Han-Yi Liu¹, Xin Fang³, Guo-Hui Zhang⁴

Affiliations

¹ Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China.
² Department of General Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310022, Zhejiang Province, China.
³ Department of Vascular Surgery, The Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China.
⁴ Department of General Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310022, Zhejiang Province, China. 1018885878@qq.com.

Abstract

Background: Through significant advances in the treatment of peripheral arterial occlusive disease, acute ischemia of the lower extremity is still associated with significant morbidity, limb threat and mortality. The two main causes of acute ischemia in lower extremities are arterial embolism and atherosclerotic arteries. Timely recognition and treatment of acute limb ischemia in emergency situations is essential in order to minimize the duration of ischemia.

Aim: To investigate the application effect of angiojet thrombolysis in the treatment of acute lower extremity arterial embolization.

Methods: Sixty-two patients with acute lower extremity arterial embolization admitted to our hospital from May 2018 to May 2020 were selected. Among them, the observation group (twenty-eight cases) had received angiojet thrombolysis, and the control group (thirty-four cases) had received femoral artery incision and thrombectomy. After thrombus clearance, significant residual stenosis of the lumen was combined with balloon dilation and/or stent implantation. When the thrombus removal was not satisfactory, catheter-directed thrombolysis was performed. The incidence of postoperative complications, recurrence rate and recovery of the two groups were compared.

Results: There were no significant differences in postoperative recurrence (target vessel reconstruction rate), anklebrachial index and the incidence of postoperative complications between the two groups (P > 0.05); there were statistically significant differences in postoperative pain score and postoperative rehabilitation between the two groups (P < 0.05).

Conclusion: The application of angiojet in the treatment of acute lower limb artery thromboembolism disease is safe and effective, minimally invasive, quicker recovery after operation, less postoperative complications, which is more suitable for the treatment of femoral popliteal arterial thromboembolism lesions. If the thrombus removal is not satisfactory, the combination of coronary artery aspiration catheter and catheterized directed thrombolysis can be used. Balloon dilation and stent implantation can be considered for obvious lumen stenosis.

Keywords: Acute lower extremity arterial embolism; Angiojet thrombectomy; Ankle brachial index; Postoperative complications; Postoperative rehabilitation.