Early and Long-Term Clinical Results of AngioJet Rheolytic Thrombectomy in Patients With Acute Pulmonary Embolism

Margheri, Massimo; Vittori, Guido; Vecchio, Silvia Lo; Chechi, Tania; Falchetti, Elena; Spaziani, Gaia; Giuliani, Gabriele; Rovelli, S.; Consoli, Lorenzo; Biondi‐Zoccai, Giuseppe

doi:10.1016/j.amjcard.2007.07.087

Cited by 72 publications

(44 citation statements)

References 10 publications

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“…Rheolytic embolectomy (the most common type being the AngioJet) injects pressurized saline into the embolus while aspirating macerated thrombus through the catheter port. Early adult data show promising results for patients with PE (47,48). A major disadvantage of this procedure is that mandatory venotomy is required for insertion, which increases the bleeding risk.…”

Section: New/emerging Conceptsmentioning

confidence: 93%

Pulmonary Embolism in Children

Ramiz

Rajpurkar

2018

Pediatric Clinics of North America

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Section: New/emerging Conceptsmentioning

confidence: 93%

Pulmonary Embolism in Children

Ramiz

Rajpurkar

2018

Pediatric Clinics of North America

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“…Although not FDA-approved for pulmonary embolism, a handful of case reports have shown the effectiveness of AngioJet® in this setting. 7,8 AngioJet® works by selectively trapping and destroying thrombi via hydraulic recirculation, whereby a hydrodynamic vortex is created by retrogradely oriented high-speed fluid jets from the tip of the AngioJet® catheter. This vortex results in a stagnant pressure gradient, which traps, solubilizes, and passively evacuates the thrombus.…”

Section: Hemolysis Caused By Thrombectomymentioning

confidence: 99%

“…9 This process also results in the mechanical lysis of red blood cells. 7,10,11 Hemolysis following use of AngioJet® has been reported, which in one case (where the device was used to treat portal vein thrombosis) caused transient elevation of the serum creatinine level. 11 The Amplatz thrombectomy device uses a similar mechanical approach to that of AngioJet®, by creating a hydrodynamic vortex to dissolve the clot.…”

Section: Hemolysis Caused By Thrombectomymentioning

confidence: 99%

Acute kidney injury caused by intravascular hemolysis after mechanical thrombectomy

et al. 2008

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Acute kidney injury caused by intravascular hemolysis after mechanical thrombectomy. Continuing Medical Education online Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. Medscape, LLC designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credits TM . Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To receive credit, please go to http://www.medscape.com/cme/ncp and complete the post-test. Learning objectivesUpon completion of this activity, participants should be able to: 1 Describe the clinical features of pulmonary embolism in a pregnant woman. 2 Describe the clinical features of intravascular hemolysis. 3 Describe the mechanism of action of the AngioJet ® . 4 Review the management of acute kidney injury associated with hemolysis. Competing interestsThe authors, the Journal Editor C Harman and the CME questions author D Lie declared no competing interests. THE CASEA 43-year-old African-American female (gravida 5 para 0), with an intrauterine pregnancy of 8 weeks' gestation, presented to the emergency room with crampy abdominal pain, shortness of breath, and shoulder pain. The patient's medical history was notable for hypertension, uterine fibroids, one spontaneous abortion in the first trimester, and three elective therapeutic abortions. She was not taking any prescription medications and had no known drug allergies. The patient's history also indicated that she had smoked one pack of cigarettes per week for 25 years, but she denied alcohol or illicit drug use. On physical examination, the patient's temperature was 36.0 °C, and she had a pulse rate of 118 beats per minute and a blood pressure of 142/87 mmHg. Oxygen saturation was 100% on a nonrebreather mask. The patient was alert S u M M a rYBackground A 43-year-old African-American female (gravida 5 para 0) with an 8-week intrauterine pregnancy presented to the emergency room with crampy abdominal pain, shortness of breath, and shoulder pain. She had normal renal function on admission. CT angiography of the chest revealed bilateral pulmonary emboli; therefore, the AngioJet® (Possis Medical, Inc., Minneapolis, MN) device was used to perform mechanical thrombolysis. The patient subsequently developed hyperkalemia, red urine and anuria.

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“…The jets fragment the thrombus and force the resultant thrombus fragments into a catheter. Margheri et al 15 reported the effectiveness and safety of rheolytic thrombectomy for acute PE. In their report, AngioJet rheolytic thrombectomy was used in 25 patients with massive or submassive PE.…”

Section: Discussionmentioning

confidence: 99%