Laila Aboulnasr MD; Tarek Ashour MD; Sherif Zamer MD
Laila Aboulnasr MD; Tarek Ashour MD; Sherif Zamer MD
Usama Lotfi (MD, MRCS) , Hisham Mostafa (MD), Maher Abdelmonem (MD), Ahmed Reyad (MD)
Magdy Haggag, Usama Lotfi, Randa Kaddah
Mohamed El-Maadawy, MD
Mohamed El-Maadawy, MD.
Ahmed M. Hussein MD., Mohamed Y. Ibrahim MD., Mohamed L. Mohamed M.Sc.
Ahmed El-Marakby, Ahmed Farghaly, Ahmed Gamal Eldin Fouad
Ashraf Abolfotooh Khalil, Amr Ibrahim Fouad, Mohamed Hazem, Ahmed F. Aborady, Hatem Elsahar, Ahmed Ragab Morsi
Mahmoud Saad Farahat MD
Fady Magdy Yacoub, Khaled Sadek, Ahmed Adel Nawar
Maged Rihan and Mohamed M.Raslan
Usama Shaker Mohamed, Mohamed Diaa Sarhan, Amr Mohsen, Ahmed Farag, Mohamed Youssef, Fahim Elbassiony
Percutaneous Mechanical Thromboectomy (PMT, AngiJet) for Treatment of Symptomatic Lower Extremity Deep Venous Thrombosis: Safety and Efficacy Study, Retrospective Study
Aim of Study: We describe our vascular center experience in thromboectomy of extensive iliofemoral deep
venous thrombosis by using PMT with or without thrombolytic agents in combination with venoplasty and
stenting for underlying venous lesions at the same session. Methodology: Over 24 months 14 patients with
extensive lower extremity DVT were treated with PMT with the AngioJet thromboectomy device in
combination with lytic agent (tissue plasminogen activator or reteplase) added to the infusion in selected
delayed cases. Venoplasty and venous stenting by using sinus venous stents (Optimed stent) were deployed
in all cases with underlying venous stenosis in the same session of the intervention. The primary end point
was angiographic evidence of restoration of venous patency at completion of the procedure.
Complications, recurrent ipsilateral DVT, and improvement in clinical symptoms were evaluated. Results:
Complete thrombus removal was obtained in 9 procedures (64%), and partial resolution in the remaining 5
procedures (36%). In the 5 procedures with partial resolution, rheolytic thromboectomy with thrombolysis
carried out. Additional catheter-directed thrombolysis was done for 12 hours in three of these five cases.
Occlusive lesions by external mass compression responsible for acute DVT were revealed in 2 patients
(14%). Underlying venous stenosis was detected in 9 patients (64%) and balloon angioplasty alone without
stenting was performed in one patient and the remaining 8 patients required stenting. 16 stents were
deployed in these 8 patients (average two stents for the patient). Overall, immediate (<24 hours)
improvement in clinical symptoms was noted in 14 patients (100%). There was only patient (1/14, 7%)
suffered of generalized bleeding and retroperitoneal hematoma from the thrombolytic agent otherwise no
major complications related to either PMT or the short duration of lytic agent infusion. 2 patients
developed access sites minor hematoma, 5 patients developed haemoglobinuria & one patient developed
severe bradycardia during the procedure. Only one patient had a recurrent thrombosis after
thromboectomy by 7 months and was treated by anticoagulation. Conclusions: Percutaneous mechanical
thromboectomy by using Angiojet machine is safe and effective method for thrombus removal in early cases
with extensive iliofemoral DVT.