Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2023; 11(15): 3491-3501
Published online May 26, 2023. doi: 10.12998/wjcc.v11.i15.3491
Observation of the effect of angiojet to treat acute lower extremity arterial embolization
Xiao-Hu Meng, Xu-Pin Xie, Yong-Chang Liu, Chang-Pin Huang, Lin-Jun Wang, Han-Yi Liu, Xin Fang, Guo-Hui Zhang
Xiao-Hu Meng, Xu-Pin Xie, Yong-Chang Liu, Lin-Jun Wang, Han-Yi Liu, Department of Vascular Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Chang-Pin Huang, Guo-Hui Zhang, Department of General Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou 310022, Zhejiang Province, China
Xin Fang, Department of Vascular Surgery, The Affiliated Hangzhou Cancer Hospital, Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Author contributions: Meng XH contributed to the study conception and writing; Meng XH and Zhang GH contributed to the data collection and investigation; Meng XH and Xie XP contributed to the analysis; all authors contributed to the critical review and revision, final approval of the article and accountability for all aspects of the work.
Supported by Hangzhou Medical Health Science and Technology Project, No. 20220919Y001; and No. 20220919Y004.
Institutional review board statement: The study was reviewed and approved by the Hangzhou First People's Hospital Institutional Review Board (Approval No.ⅡT-20221218-0201-01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflict of interest.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Hui Zhang, MBChB, Nurse, Department of General Surgery, The Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 469 Shenban Road, Hangzhou 310022, Zhejiang Province, China. 1018885878@qq.com
Received: January 25, 2023
Peer-review started: January 25, 2023
First decision: March 14, 2023
Revised: March 25, 2023
Accepted: April 13, 2023
Article in press: April 13, 2023
Published online: May 26, 2023
Processing time: 120 Days and 13 Hours
Abstract
BACKGROUND

Through significant advances in the treatment of peripheral arterial occlusive disease, acute ischemia of the lower extremity is still associated with significant morbidity, limb threat and mortality. The two main causes of acute ischemia in lower extremities are arterial embolism and atherosclerotic arteries. Timely recognition and treatment of acute limb ischemia in emergency situations is essential in order to minimize the duration of ischemia.

AIM

To investigate the application effect of angiojet thrombolysis in the treatment of acute lower extremity arterial embolization.

METHODS

Sixty-two patients with acute lower extremity arterial embolization admitted to our hospital from May 2018 to May 2020 were selected. Among them, the observation group (twenty-eight cases) had received angiojet thrombolysis, and the control group (thirty-four cases) had received femoral artery incision and thrombectomy. After thrombus clearance, significant residual stenosis of the lumen was combined with balloon dilation and/or stent implantation. When the thrombus removal was not satisfactory, catheter-directed thrombolysis was performed. The incidence of postoperative complications, recurrence rate and recovery of the two groups were compared.

RESULTS

There were no significant differences in postoperative recurrence (target vessel reconstruction rate), anklebrachial index and the incidence of postoperative complications between the two groups (P > 0.05); there were statistically significant differences in postoperative pain score and postoperative rehabilitation between the two groups (P < 0.05).

CONCLUSION

The application of angiojet in the treatment of acute lower limb artery thromboembolism disease is safe and effective, minimally invasive, quicker recovery after operation, less postoperative complications, which is more suitable for the treatment of femoral popliteal arterial thromboembolism lesions. If the thrombus removal is not satisfactory, the combination of coronary artery aspiration catheter and catheterized directed thrombolysis can be used. Balloon dilation and stent implantation can be considered for obvious lumen stenosis.

Keywords: Acute lower extremity arterial embolism; Angiojet thrombectomy; Postoperative complications; Ankle brachial index; Postoperative rehabilitation

Core Tip: Acute lower extremity arterial embolism is a common clinical emergency. It has the characteristics of rapid onset and rapid development. If left untreated, irreversible damage to limb tissue can occur within hours. Therefore, the key to the treatment of acute lower extremity arterial embolism is to seize the time and implement effective treatment plan is of great significance. Angiojet thrombectomy is a minimally invasive technique to remove thrombectomy through percutaneous insertion of catheters. The objective of this study was to investigate the application effect of angiojet thrombectomy in the treatment of acute lower extremity arterial embolization.