Percutaneous Thrombectomy in Patients with Occlusions of the Aortoiliac Segment: A Case Series View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2022-08-24

AUTHORS

Malte Maria Sieren, Julian Pfarr, Schekeb Aludin, Karim Mostafa, Erik Stahlberg, Franz Wegner, Sam Mogadas, Rene Rusch, Marco Horn, Philipp Schäfer

ABSTRACT

ObjectiveThrombectomy of the aortoiliac segment remains a challenge for surgical and endovascular revision. This study aimed to evaluate the concept of percutaneous thrombectomy in patients with aortoiliac segment occlusions.Materials & MethodsEighteen patients with aortoiliac occlusion who underwent percutaneous thrombectomy were retrospectively identified using the local picture archive and divided into the stent-graft (N = 10) and native vessels (N = 8) groups. The procedure was performed by placing a 12–24 French sheath adjacent to the distal end of the occluded vessel segment. The occlusion was passed with a balloon catheter which was retracted after inflation, to deliver the thrombus into the sheath. Technical success (reperfusion of the vessel and no residual thrombus/stenosis < 30%), complications and primary arterial patency were assessed. Follow-up included computed tomography angiography and evaluation of the clinical situation via telephone.ResultsTechnical success was achieved in 38% (7/18) of patients after percutaneous thrombectomy alone and in 100% after additional procedures. The most common complication was peripheral embolism (44%, 8/18), which was treated successfully in all cases and was linked to a mismatch between the sheath and target vessel of ≥ 1 mm (P < .01). There were no significant differences in the incidence of complications between the two groups. Primary patency was 72% (13/18) with no significant difference between groups (P = .94). Follow-up CT scans were available for 13/18 patients (72%), with a mean follow-up time of 270 ± 146 days. All patients were contacted via phone (follow-up time, 653 ± 264 days).ConclusionPercutaneous thrombectomy appears to be effective for revascularization of the aortoiliac segment, both in stent-grafts and in native vessels. The most common complication is peripheral embolism; however, the risk may be reduced by choosing an adequate sheath size. More... »

PAGES

1684-1692

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00270-022-03222-y

DOI

http://dx.doi.org/10.1007/s00270-022-03222-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1150460295

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/36002537


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