Efficacies of AngioJet and AcoStream on subacute lower limb deep vein thrombosis
Objective To compare the efficacy and safety of AngioJet versus AcoStream thrombectomy devices in percutaneous mechanical thrombectomy for subacute lower limb deep vein thrombosis(DVT).Methods From December,2019 to May,2023,87 patients with subacute lower limb DVT underwent percutaneous mechanical thrombectomy in Xinxiang Central Hospital,among whom 54 patients used AngioJet thrombectomy device(AngioJet group)and 33 patients used AcoStream thrombectomy device(AcoStream group).The clinical data such as the etiology,thrombotic site and thrombotic range were compared between two groups.The time of thrombus aspiration,intraoperative blood loss,amount of urokinase,implantation of iliac vein stents,catheter-directed thrombolysis,thrombus clearance rate,limb swelling reduction rate,length of hospital stay,and postoperative complications as hematuria were recorded in two groups.The patients were followed up for 6 to 36 months after operation,and the recurrence rate of thrombosis,incidence of deep vein post-thrombotic syndrome,and Villalta score were compared between two groups.Results There were no significant differences in the etiology,thrombotic site and thrombotic range between two groups(P＞0.05).The thrombus aspiration time was shorter in Angiojet group[(343.6±85.4)s]than that in AcoStream group[(587.7±97.2)s](t=6.549,P=0.025),the intraoperative blood loss was less in AngioJet group[(217.9±73.1)mL]than that in AcoStream group[(325.5±87.5)mL](t=7.562,P=0.019),and there were no significant differences in the amount of urokinase,iliac vein stent implantation rate,auxiliary catheter-directed thrombolysis rate,thrombus clearance rate,limb swelling reduction rate,and length of hospital stay between two groups(P＞0.05).The incidence of postoperative hematuria was higher in Angiojet group(90.7％)than that in AcoStream group(3.0％)(x2=30.299,P＜0.001),and there was no significant difference in the incidence of other complications between Angiojet group(3.7％)and AcoStream group(3.0％)(x2=0.192,P=0.661).During a follow-up period of 6-36 months,there were no significant differences in the rates of thrombosis recurrence,post-thrombotic syndrome and Villalta score between Angiojet group(17.6％,9.8％,9.5±4.5)and AcoStream group(15.6％,9.4％,8.5±5.5)(P＞0.05).Conclusions Both Angiojet and AcoStream mechanical thrombectomy devices are safe and effective in treating subacute lower limb DVT,among which AngioJet thrombectomy is more efficient and minimally invasive.Although the incidence of postoperative hematuria is high,the prognosis is not affected after quick recovery.
lower limb deep vein thrombosissubacutepercutaneous mechanical thrombectomyAngioJetAcoStream
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