Abstract:
Background: The aim of this study was to compare the effectiveness and the safety of endovascular therapy with rheolytic thrombectomy using the AngioJet™ vs. aspiration thrombectomy using the Penumbra CAT™ for treatment of the visceral ischemia caused by occluding lesions in the visceral arteries.
Methods: A retrospective data collection was conducted from patients treated between January 2013 and December 2024. Totally of 57 cases have been diagnosed with mesenteric or renal ischemia and treated by endovascular means in a tertiary institution. Fifteen patients were treated with only with AngioJet™ device, whereas 34 patients were treated primarly with Penumbra™ device. Primary endpoints were a combination of technical success and mortality, secondary endpoint were return to the operating theatre within 30 days, major cardio and cerebrovascular events, access site complications, end organ damage which includes dialysis or bowel resection.
Results: A total of 57 endovascular thrombectomies were performed on 49 patients with visceral ischemia using the AngioJet™ and Penumbra CAT™ devices with an average age of 68.27 years (68.27±10.4), including 36 males and 13 females. The overall success rate was 89.94% (51 out of 57), and the patients were discharged with a patent target artery. A total of 15 procedures were performed using the AngioJet™ device. In 7 cases, the superior mesenteric artery was the affected
artery, and in the remaining 8 cases, the renal arteries were affected. This resulted in a technical success rate of 93.33% (14 out of 15). No recurrence was observed. Overall, 80.00%(12 cases) were performed through surgical cutdown and under general anesthesia. A total of 34 procedures were performed with the Penumbra™ device, with 15 cases targeting mesenteric arteries, 19 targeting renal arteries. A total of eight recurrent cases were documented. In 85.29% (29 out of 34) of cases, vascular access was obtained through a surgical cut technique, while in 94.1% (32 out of 34) of cases, the intervention was conducted under general anesthesia. The documented technical success rate was found to be 88.23% (30 out of 34).
Conclusions: In this single center experience both devices are both feasible and safe. However, the AngioJet™ demonstrated higher safety and effectiveness, as well as reduced invasiveness and the recurrence rate.
Biography:
Dr. Bachar Al Haj is a resident doctor in the Department of Vascular and Endovascular Surgery at St. Franziskus Hospital in Münster, Germany. He is presently enrolled as a PhD student at the University of Münster. Dr. Al Haj has participated in various volunteer projects and has recently published extensively on the endovascular treatment of visceral ischemia.
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