Rheolytic thrombectomy with the Possis AngioJet: technical considerations and initial clinical experience.
Percutaneous revascularization of thrombus-containing lesions has an increased incidence of adverse events such as abrupt vessel closure, periprocedural myocardial infarction and death. Various pharmacologic and mechanical approaches have demonstrated modest angiographic success with significant periprocedural complications. The AngioJet (Possis Medical, Inc., Minneapolis, Minnesota) is a dual lumen catheter that uses the principle of rheolytic thrombectomy to remove unorganized thrombus. A previously unreported scoring system based on clinical and angiographic data may help to select patients most likely to benefit from AngioJet treatment. When compared with urokinase in the randomized VeGAS 2 Trial, AngioJet therapy yields greater angiographic success with a lower incidence of 30-day major adverse events. Technical considerations and complications are reviewed in detail.
Whisenant
B K
BK
Beth Israel Deaconess Medical Center, East Campus, 330 Brookline Avenue, Boston, MA 02215, USA.
Baim
D S
DS
Kuntz
R E
RE
Garcia
L A
LA
Ramee
S R
SR
Carrozza
J P
JP
D002404:Catheterization; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003328:Coronary Thrombosis / Q000209:etiology / Q000628:therapy*; D004867:Equipment Design; D018056:Hemorheology; D006801:Humans; D010960:Plasminogen Activators / Q000009:adverse effects / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use
D012965:Sodium Chloride; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator