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Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization

OBJECTIVES: To evaluate the efficacy of percutaneous aspiration thrombectomy (PAT) for infrainguinal arterial thromboembolism in patients undergoing endovascular recanalization (EVR) and to investigate the predictors for thromboembolic complications. MATERIALS AND METHODS: In total, 23 patients (23...

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Autores principales: Wei, Li-Ming, Zhu, Yue-Qi, Liu, Fang, Zhang, Pei-Lei, Li, Xiao-Cong, Zhao, Jun-Gong, Lu, Hai-Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618847/
https://www.ncbi.nlm.nih.gov/pubmed/26484672
http://dx.doi.org/10.1371/journal.pone.0140494
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author Wei, Li-Ming
Zhu, Yue-Qi
Liu, Fang
Zhang, Pei-Lei
Li, Xiao-Cong
Zhao, Jun-Gong
Lu, Hai-Tao
author_facet Wei, Li-Ming
Zhu, Yue-Qi
Liu, Fang
Zhang, Pei-Lei
Li, Xiao-Cong
Zhao, Jun-Gong
Lu, Hai-Tao
author_sort Wei, Li-Ming
collection PubMed
description OBJECTIVES: To evaluate the efficacy of percutaneous aspiration thrombectomy (PAT) for infrainguinal arterial thromboembolism in patients undergoing endovascular recanalization (EVR) and to investigate the predictors for thromboembolic complications. MATERIALS AND METHODS: In total, 23 patients (23 limbs) who underwent PAT for thromboembolism (PAT group, PG) during EVR and 237 patients (302 limbs) who underwent successful EVR without thromboembolic complications (control group, CG) were enrolled. Immediate post-operation and follow-up outcomes were compared between the two groups. Multivariate analysis was performed to identify the predictors of thromboembolic complications. Technical success of PAT was defined as achievement of <30% residual stenosis and restoration of mTIMI grade 3. RESULTS: The technical success rate was 95.7% in PG. After intervention, the ankle–brachial index (ABI), restoration of blood flow and improvement in dorsal/plantar arterial pulse score showed no significant differences between PG and CG. During follow-up in PG, a sustained ABI improvement was observed in 63.6% (70.9% in CG), an improvement in walking distance in 68.8% (79.9% in CG,), ulcer healing in 75.0% (71.7% in CG) and restenosis/occlusion in 31.8% (25.2% in CG). The limb salvage rate was 100% in PG (96.0% in CG), and pain relief was observed in 66.7% patients with critical limb ischaemia (81.6% in CG). Superficial femoral artery involvement [0.233; 95% confidence interval (CI), 0.108–0.461; P < 0.001], de-novo lesion occlusion (683.8; 95% CI, 36.5–12804.6; P < 0.001) and intraluminal angioplasty (118.4; 95% CI, 8.0–1758.0; P = 0.001) was associated with high incidence of thromboembolism. CONCLUSION: PAT is a safe and effective treatment for thromboembolism during infrainguinal arterial EVR. SFA involvement, de-novo lesion occlusion and intraluminal angioplasty may be predictors of thromboembolic complications.
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spelling pubmed-46188472015-10-29 Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization Wei, Li-Ming Zhu, Yue-Qi Liu, Fang Zhang, Pei-Lei Li, Xiao-Cong Zhao, Jun-Gong Lu, Hai-Tao PLoS One Research Article OBJECTIVES: To evaluate the efficacy of percutaneous aspiration thrombectomy (PAT) for infrainguinal arterial thromboembolism in patients undergoing endovascular recanalization (EVR) and to investigate the predictors for thromboembolic complications. MATERIALS AND METHODS: In total, 23 patients (23 limbs) who underwent PAT for thromboembolism (PAT group, PG) during EVR and 237 patients (302 limbs) who underwent successful EVR without thromboembolic complications (control group, CG) were enrolled. Immediate post-operation and follow-up outcomes were compared between the two groups. Multivariate analysis was performed to identify the predictors of thromboembolic complications. Technical success of PAT was defined as achievement of <30% residual stenosis and restoration of mTIMI grade 3. RESULTS: The technical success rate was 95.7% in PG. After intervention, the ankle–brachial index (ABI), restoration of blood flow and improvement in dorsal/plantar arterial pulse score showed no significant differences between PG and CG. During follow-up in PG, a sustained ABI improvement was observed in 63.6% (70.9% in CG), an improvement in walking distance in 68.8% (79.9% in CG,), ulcer healing in 75.0% (71.7% in CG) and restenosis/occlusion in 31.8% (25.2% in CG). The limb salvage rate was 100% in PG (96.0% in CG), and pain relief was observed in 66.7% patients with critical limb ischaemia (81.6% in CG). Superficial femoral artery involvement [0.233; 95% confidence interval (CI), 0.108–0.461; P < 0.001], de-novo lesion occlusion (683.8; 95% CI, 36.5–12804.6; P < 0.001) and intraluminal angioplasty (118.4; 95% CI, 8.0–1758.0; P = 0.001) was associated with high incidence of thromboembolism. CONCLUSION: PAT is a safe and effective treatment for thromboembolism during infrainguinal arterial EVR. SFA involvement, de-novo lesion occlusion and intraluminal angioplasty may be predictors of thromboembolic complications. Public Library of Science 2015-10-20 /pmc/articles/PMC4618847/ /pubmed/26484672 http://dx.doi.org/10.1371/journal.pone.0140494 Text en © 2015 Wei et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Wei, Li-Ming
Zhu, Yue-Qi
Liu, Fang
Zhang, Pei-Lei
Li, Xiao-Cong
Zhao, Jun-Gong
Lu, Hai-Tao
Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization
title Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization
title_full Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization
title_fullStr Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization
title_full_unstemmed Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization
title_short Percutaneous Aspiration Thrombectomy for Arterial Thromboembolism during Infrainguinal Endovascular Recanalization
title_sort percutaneous aspiration thrombectomy for arterial thromboembolism during infrainguinal endovascular recanalization
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4618847/
https://www.ncbi.nlm.nih.gov/pubmed/26484672
http://dx.doi.org/10.1371/journal.pone.0140494
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