title: Endovascular Management of Deep Vein Thrombosis with Rheolytic Thrombectomy: Final Report of the Prospective Multicenter PEARL (Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths) Registry.
abstract: OBJECTIVE
  To report procedural and patient outcomes of endovascular treatment for lower-extremity deep vein thrombosis (DVT) with rheolytic thrombectomy (RT).
  
  
  METHODS
  A total of 32 sites in the United States and Europe enrolled patients with DVT in the Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths (PEARL) registry. Patient characteristics and outcomes data were collected from consenting patients who underwent rheolytic AngioJet thrombectomy at investigative sites from January 2007 through June 2013. Three hundred twenty-nine patients were enrolled, with 67% of patients undergoing an AngioJet procedure within 14 days of the onset of symptoms.
  
  
  RESULTS
  Four treatment approaches using AngioJet thrombectomy were identified: RT without lytic agent in 4% of patients (13 of 329), pharmacomechanical catheter-directed thrombolysis (PCDT) in 35% (115 of 329), PCDT and catheter-directed thrombolysis (CDT) in 52% (172 of 329), and RT in combination with CDT in 9% (29 of 329). Median procedure times for RT alone, PCDT, PCDT/CDT, and RT/CDT were 1.4, 2, 22, and 41 hours, respectively (P < .05, Kruskal-Wallis test). Procedures were completed in less than 24 hours for 73% of patients, with 36% of procedures completed within 6 hours; 86% of procedures required no more than 2 catheter laboratory sessions. The 3-, 6-, and 12-month freedom from rethrombosis rates were 94%, 87%, and 83%, respectively. Major bleeding events occurred in 12 patients (3.6%), but none were related to the AngioJet procedure.
  
  
  CONCLUSIONS
  PEARL registry data demonstrate that rheolytic PCDT treatment of DVT is safe and effective, and can potentially reduce the need for concomitant CDT and intensive care.
authors.affiliation: Vascular Interventional Radiology , Christiana Care Health Services, Suite 1E20, 4755 Ogletown-Stanton Rd., Newark, DE 1 3 x. ?9708. Electronic address: magarcia@christianacare.org.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Garcia
authors.affiliation: Department of Interventional Radiology, Mount Sinai Medical Center, New York, New York.
authors.forename: Robert
authors.initials: R
authors.lastname: Lookstein
authors.affiliation: Department of Interventional Cardiology, Phoenix Heart, Glendale, Arizona.
authors.forename: Rahul
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Department of Vascular Surgery (A.A.), Reading Hospital, Reading, Pennsylvania.
authors.forename: Ali
authors.initials: A
authors.lastname: Amin
authors.affiliation: Department of Interventional Cardiology (L.R.B.), Chilton Memorial Medical Center, Pompton Plains, New Jersey.
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Blitz
authors.affiliation: Vascular Interventional Radiology , Christiana Care Health Services, Suite 1E20, 4755 Ogletown-Stanton Rd., Newark, DE 1 3 x. ?9708.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Leung
authors.affiliation: Heart and Vascular Institute (E.J.S.), Penn State Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Eugene J
authors.initials: EJ
authors.lastname: Simoni
authors.affiliation: Department of Interventional Cardiology (P.A.S), Miriam Hospital/Rhode Island Hospital, Providence, Rhode Island.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Soukas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005060:Europe; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation*; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D062666:Vascular Access Devices; D020246:Venous Thrombosis / Q000175:diagnosis / Q000628:therapy*; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents