title: AngioJet rheolytic thrombectomy for acute superficial femoral artery stent or femoropopliteal by-pass thrombosis.
abstract: Thrombosis of superficial femoral artery (SFA) nitinol stents or polytetrafluoroethylene (PTFE) femoropopliteal bypass grafts after discontinuation of antiplatelet therapy is an emergent clinical challenge of acute limb ischemia (ALI), requiring immediate percutaneous intervention. Currently, there is no evidence-based approach for the management of such complications. We describe the cases of two patients presenting with ALI due to nitinol stent thrombosis after discontinuation of antiplatelet therapy and the case of a patient presenting with ALI due to PTFE femoropopliteal graft thrombosis in which limb salvage was obtained by AngioJet rheolytic thrombectomy and re-stenting. In both cases, the thrombus was successfully removed using the Possis AngioJet mechanical thrombectomy catheter and percutaneous transluminal angioplasty (PTA) was performed to recanalize two femoropopliteal nitinol stents and a femoropopliteal PTFE graft. In both cases, optimal angiographic result was obtained. To the best of our knowledge, these are the first three cases reporting the use of the AngioJet rheolytic thrombectomy in ALI due to stent or graft thrombosis. Taken together, these cases suggest that AngioJet rheolytic thrombectomy might represent a novel effective strategy in the percutaneous treatment of stent or graft thrombosis determining ALI.
authors.affiliation: Division of Cardiology, Federico II University of Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Borgia
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Serafino
authors.forename: Anna
authors.initials: A
authors.lastname: Sannino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gargiulo
authors.forename: Gabriele Giacomo
authors.initials: GG
authors.lastname: Schiattarella
authors.forename: Mario
authors.initials: M
authors.lastname: De Laurentis
authors.forename: Laura
authors.initials: L
authors.lastname: Scudiero
authors.forename: Cinzia
authors.initials: C
authors.lastname: Perrino
authors.forename: Federico
authors.initials: F
authors.lastname: Piscione
authors.forename: Giovanni
authors.initials: G
authors.lastname: Esposito
authors.forename: Massimo
authors.initials: M
authors.lastname: Chiariello
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D011150:Popliteal Artery / Q000601:surgery*; D012212:Rheology; D015607:Stents; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000601:surgery*; D014656:Vascular Surgical Procedures