Journal «Angiology and Vascular Surgery» • 

1999 • VOLUME 5 • №3

INITIAL EXPERIENCE OF TRANSCUTANEOUS RHEOLYTIC THROMBECTOMY FOR PERIPHERAL MAJOR ARTERIAL LESIONS

V.V. Demin, V.V. Zelenin, A.N. Zheludkov, I.P. Kicha, V.N. Skovorodnikov, A.G. Degtyarev
Department of Interventional Radiology Orenburg Regional Clinical Hospital,
Orenburg, Russia

Transcutaneous rheolytic thrombectomy with Angiojet complex was performed for the first time in Russia in the Department of Cardiovascular Interventional Radiology Orenburg Regional Clinical Hospital in 6 patients with lesions of peripheral major vessels. In 5 cases vascular lesions were caused by progressive atherosclerosis, in 1 case – arterial thrombosis of sutured iatrogenic vascular damage. In 3 patients rest pain was registered. Thrombus extended on 6 to 35 cm, 19.5 cm in average. In addition to femoro-popliteal lesions occlusions of 1 to 3 tibial arteries was observed. Time interval between thrombus formation and surgery was from several hours to 2 months. Thrombectomy was performed by complex Angiojet with antegrade injections through introducer 8 F. Each segment was passed by catheter 3 to 6 times, mean procedure duration was 5 min. Thrombectomy in all patients was followed by balloon angioplasty of "causative" stenoses and in 1 case – by implantation of 2 stents into femoral artery. Good early results were achieved in all patients: reconstruction area was patient, pulsation of peripheral arteries was restored in majority of cases, painless walking distance increased from 20-50 m to 500-700 m, of trophic foot changes regressed. Two patients were examined 3-4 months after operation and demonstrated stable positive clinical effect. Initial experience with rheolytic thrombectomy by Angiojet complex showed high efficiency, safety, minimal invasiveness of the procedure, enabling to expand significantly options for radiosurgical management of vascular diseases.

KEY WORDS: Transcutaneous rheolytic thrombectomy, lower limb arterial thrombosis.

P. 55-63

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