title: Efficacy and safety of catheter-based rheolytic and aspiration thrombectomy in children.
abstract: BACKGROUND
  Vascular thromboses are a significant cause of morbidity and mortality in children. Data in children regarding catheter-based rheolytic and aspiration thrombectomy systems are limited. We sought to review the safety and efficacy of catheter-based rheolytic and aspiration thrombectomy systems in children.
  
  
  METHODS
  Data of all children having undergone thrombectomy using specialized rheolytic or aspiration systems were reviewed.
  
  
  RESULTS
  Thrombectomy was performed in 50 vessels in 21 patients, median age 1.9 months (8 days-18 yrs), median weight 4.3 (1.1-67.9) kg. Thrombectomy was performed using AngioJet in 16, Helix Clot Buster in 5, Fetch catheter in 8, Pronto catheter in 1, and a combination of other systems in 20 vessels (with AngioJet in 16). Thrombectomy was successful in 47/50 (94%) vessels in 18/21 (86%) patients with additional balloon/stent therapy or tPA administration performed in 16/18 (89%) of these patients. There were 2 (9.5%) major complications (both with AngioJet) consisting of asystole when thrombectomy was performed using activation times of >5 sec. At a median follow-up of 10 months (2 weeks-7 years), all 47 successfully treated vessels are patent, with 8/18 (44%) patients requiring reintervention with angioplasty/stent placement or repeat thrombectomy.
  
  
  CONCLUSIONS
  Catheter-based thrombectomy systems are an important adjunctive tool in the treatment of children with thrombotic vessel occlusions. Significant hemodynamic compromise seen when using AngioJet may be minimized by using activation times of ≤5 sec. © 2016 Wiley Periodicals, Inc.
authors.affiliation: The Lillie Frank Abercrombie Section of Cardiology, CE Mullins Cardiac Catheterization Laboratories, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Athar M
authors.initials: AM
authors.lastname: Qureshi
authors.affiliation: The Lillie Frank Abercrombie Section of Cardiology, CE Mullins Cardiac Catheterization Laboratories, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Petit
authors.affiliation: The Lillie Frank Abercrombie Section of Cardiology, CE Mullins Cardiac Catheterization Laboratories, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Crystal
authors.affiliation: The Lillie Frank Abercrombie Section of Cardiology, CE Mullins Cardiac Catheterization Laboratories, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Aimee
authors.initials: A
authors.lastname: Liou
authors.affiliation: The Lillie Frank Abercrombie Section of Cardiology, CE Mullins Cardiac Catheterization Laboratories, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Asra
authors.initials: A
authors.lastname: Khan
authors.affiliation: The Lillie Frank Abercrombie Section of Cardiology, CE Mullins Cardiac Catheterization Laboratories, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Henri
authors.initials: H
authors.lastname: Justino
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017130:Angioplasty / Q000295:instrumentation; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010690:Phlebography; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D017131:Thrombectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013927:Thrombosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices; D014654:Vascular Patency; D020246:Venous Thrombosis / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*
keywords: congenital heart disease; pediatric intervention; pediatrics; vascular complications