Percutaneous aspiration thrombectomy in the treatment of lower extremity thromboembolic occlusions.
OBJECTIVE
To report the immediate and midterm results of manual aspiration thrombectomy as the first thrombus removal method in the treatment of acute or early chronic arterial thromboembolism in the lower extremity.


METHODS
Retrospective review of 40 limbs in 37 nonconsecutive patients between March 2006 and March 2008 (21 female [57%], 16 male; mean age, 67 +/- 10 years; age range, 42-84 years) who had percutaneous aspiration thrombectomy for lower limb arterial thromboembolism. Twenty-nine legs had acute ( < 14 days) and 11 legs had early chronic (15-60 days) thromboembolism. Clinical categories of limb ischemia were stage I in 12 limbs, stage IIa in 17 limbs, and stage IIb in 11 limbs.


RESULTS
Technical success was achieved in 35 limbs (88%). Complete thrombus removal was achieved in 26 of 29 limbs (90%) with acute occlusions and 4 of 11 limbs (36%) with early chronic occlusions (P < 0.05, chi(2) test). Amputation-free survival rate was 100% at one month, 93% at one year, and 93% at two years with Kaplan-Meier survival analysis. Freedom from symptoms of claudication or critical limb ischemia was achieved in 31 of 39 limbs (80%) at one month and 25 of 35 limbs (71%) at one year. There were three major complications and ten minor complications.


CONCLUSIONS
Percutaneous aspiration thrombectomy is a rapid and effective way of removing thrombus in thromboembolic occlusions of the limb arteries below the inguinal ligament. It can be used in patients with acute limb ischemia (Rutherford clinical category IIb).
Oğuzkurt
Levent
L
Department of Radiology, Başkent University School of Medicine, Ankara, Turkey. loguzkurt@yahoo.com
Ozkan
Uğur
U
Gümüş
Burçak
B
Coşkun
Isa
I
Koca
Nihal
N
Gülcan
Oner
O
D000368:Aged; D000792:Angiography; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D017131:Thrombectomy / Q000379:methods*; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000601:surgery*