title: Technical Results of Vacuum-Assisted Thrombectomy for Arterial Clot Removal in Patients with Acute Limb Ischemia.
abstract: OBJECTIVE
  To assess the efficacy and safety of a vacuum-assisted thrombectomy (VAT) catheter system for treating patients with acute limb ischemia (ALI).
  
  
  METHODS
  A retrospective study evaluated VAT systems (Penumbra, Alameda, California) in a consecutive series of 30 patients with ALI. ALI was defined as clinical symptoms within 2 weeks of presentation. The primary endpoint was improvement in blood flow across a lesion by improvement in Thrombolysis in Myocardial Infarction (TIMI) score that was adapted to peripheral arteries. Concomitant balloon angioplasty or stent placement in addition to VAT was considered a complementary treatment. Additional thrombectomy treatments, such as thrombolysis and mechanical thrombectomy, were considered technical failures. Target lesions were grouped anatomically into above-the-knee (ATK) or below-the-knee (BTK) lesions.
  
  
  RESULTS
  In 30 patients, 33 lesions (ATK, n = 13; BTK, n = 20) were treated. No complications were attributed to the VAT systems. The primary endpoint was obtained in 24/33 (72.7%) lesions (BTK, 17/20 [85.0%]; ATK, 7/13 [53.9%]; P = .050 by χ(2) test). TIMI scores were similar at baseline but differed after VAT between the ATK and BTK groups (P < .025 by t test). ATK lesions required more concomitant angioplasty or stent placement, or both (P < .015 by χ(2) test).
  
  
  CONCLUSIONS
  VAT is a safe, technically successful short-term therapeutic option for thrombus removal in patients with ALI.
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176.
authors.forename: Frederic
authors.initials: F
authors.lastname: Baumann
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176.
authors.forename: Emerson
authors.initials: E
authors.lastname: Sharpe
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176.
authors.forename: Constantino
authors.initials: C
authors.lastname: Peña
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176.
authors.forename: Shaun
authors.initials: S
authors.lastname: Samuels
authors.affiliation: Miami Cardiac & Vascular Institute, Baptist Hospital of Miami, 8900 North Kendall Drive, Miami, FL 33176. Electronic address: JamesB@baptisthealth.net.
authors.forename: James F
authors.initials: JF
authors.lastname: Benenati
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000295:instrumentation; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014618:Vacuum; D014654:Vascular Patency