. 2023 Jan 24;23(1):1–244.

Table 3:

Characteristics of Included Arterial Acute Limb Ischemia Studies

Author, year, country	Study design (recruitment period)	Population	Methodological approach (inclusion/exclusion criteria)	Study groups MT	Comparator	Follow-up period
Byrne et al, 2014⁷⁶ United States	Retrospective, single centre (2005-2011)	N = 154 Acute limb ischemia Rutherford class I, IIa, or IIb Most common cause was a failed bypass or failed stent	All patients received rtPA Selection of intervention at operator's discretion PCDT was avoided in patients with prosthetic bypass grafts and tibial vessels by some operators	n = 71 PMT with/out CDT AngioJet	n = 83 CDT alone	Mean: 15.2 mo (range: 56-56.84 mo)
Chait et al, 2019⁷⁴ United States	Retrospective, single centre (2006-2008)	N = 91 Intra-arterial thrombolysis in acute limb ischemia Rutherford I or IIa Symptom onset < 2 wk	Status confirmed by duplex ultrasonography with hypoechoic thrombus. and patients received angiogram and given heparin Excluded patients with contraindications for thrombolysis Decision for intervention at the discretion of the operating surgeon	n = 22 All patients received AngioJet Ultrasound-assisted CDT with continuous tPA infusion EKOS	n = 69 All patients received AngioJet CDT for tPA Uni-Fuse multi-hole infusion catheter	30 d
de Athayde Soares et al, 2020⁷⁷ Brazil	Retrospective, single centre (July 2015 to December 2018)	N = 49 Acute limb ischemia Rutherford class I, Iia, or Iib 29% iliac; 55% femoropopliteal, 16% infrapopliteal	Duplex ultrasound or arteriography to confirm Vascular surgeon discretion for selection of intervention Excluded patients who received open surgery All patients received IV heparin for 48 h	n = 18 PMT AngioJet Solent Omni	n = 31 CDT with intraarterial rtPA (Actylise)	Mean: 760 d (SD ± 80 d)
Escobar et al, 2017⁷⁸ United States	Retrospective, single centre (2007-2013)	N = 102 People treated with endovascular techniques for thrombotic syndromes^a Patient population included both arterial (n = 78) and venous (n = 24) thrombus³	Intervention selection and use of adjuvant treatments, including open surgery, were at the discretion of the treating physicians	n = 52, (34 arterial and 18 venous) PMT AngioJet	n = 50, (44 arterial and 6 venous) CDT	3 d
Gandhi et al, 2018⁷⁹ United States	Retrospective single centre (January 2008 to April, 2014	N = 83 Acute limb ischemia Rutherford class I, IIa, or IIb Variation of location, most common being superficial femoral	Arteriography to confirm Treatment approach was selected in consultation with patient	n = 54 PMT AngioJet	n = 29 CDT tPA through multiple side hole infusion catheter	Median: 15.8 and 24.0 mo for MT and control groups, respectively
Gong et al, 2021¹ China	Retrospective single centre (January 2015 to July 2019)	N = 98 Acute limb ischemia (mean time from symptoms to presentation, 31-37 h) Rutherford class I, IIa, or IIb Variation in location, most common being iliac, iliofemoral, and femoropopliteal arterials	All patients received rtPA Adjuvant thrombolysis and adjunctive angioplasty and stenting were provided at clinician discretion Intervention selected by interventional radiologist operator considering severity of disease and availability of technology	n = 57 MT + CDT Large bore catheter (n = 28), Rotarex (n =13), or AngioJet (n = 16)	n = 41 CDT alone	12 mo
Hundt et al, 2013⁸⁰ Germany	Retrospective single centre (2007-2012)	N = 75 Acute and subacute femoropopliteal bypass occlusions Defined as presentation of symptoms within: acute < 14 d from start of symptoms^b; Rutherford class I, IIa, or IIb	Treatment option was selected in consultation with vascular surgeon and based on availability of an interventional radiologist familiar with the rotational atherothrombectomy catheter Patients were excluded if no safe intraluminal guidewire passage was possible	n = 35 Percutaneous MT + thrombolysis Rotarex	n = 40 Thrombolysis alone Local fibrinolysis	6 mo
Kronlage et al, 2017⁸¹ Germany	Retrospective single centre (2006-2015)	N = 202 (Sub)acute limb ischemia Defined as presentation of symptoms within: acute: < 2 wk; subacute: 2-4 wk	All patients receive heparin and balloon dilation or stent, as indicated 26 patients were critically ill with severe sepsis, acute cardiac failure, or coronary syndrome, pulmonary embolism, chronic renal failure, or stroke	n = 146 Rotational thrombectomy alone Rotarex n = 28 Rotational thrombectomy + thrombolysis	n = 28 rtPA Cragg-McNamara catheter Continuously administered for 18 h	1 y
Morrow et al, 2017⁷³ United States	Retrospective, single centre (January 2009 to December 2014)	N = 53 Arterial thrombosis^c	Procedural method was based on physician discretion	n = 10 Percutaneous MT alone Brand not specified, but references to AngioJet n = 16 Percutaneous MT with tPA n = 14 Percutaneous MT with CDT	n = 13 CDT alone	6 mo
Muli Jogi et al, 2018⁸² Singapore	Retrospective, single centre (2006-2015)	N = 94 Acute limb ischemia	Treatment choice based on clinical scenario and operator choice Additional procedures such as balloon maceration and aspiration were at physician discretion	n = 28 Percutaneous MT Rotarex (n = 10) or AngioJet (n = 18)	n = 89 CDT Urokinase using the Craig McNamara catheter Simultaneous heparin for 6 h; additional intervention as needed	30 d
Puangpunngam et al, 2020⁸³ Thailand	Retrospective, single centre (November 2014 to April 2017)	N = 34 Acute and subacute lower limb ischemia (<30 d from symptom onset) Rutherford class IIa and IIb	All patients received heparin preoperatively, and anticoagulants and antiplatelets postoperatively Post procedural angioplasty or stenting, as indicated Treatment approach was selected by surgeon on duty on a case-by-case basis	n = 12 Percutaneous MT Rotarex	n = 22 CDT rtPA for 6-24 h	3 mo
Schernthaner et al, 2014⁸⁴ United States	Retrospective, single centre (August 2005 to February 2012)	N = 102 Acute ischemia Rutherford class I, IIa	Treatment approach was at the discretion of the performing clinician	n = 75 UAT EKOS	n = 27 CDT Uni*Fuse Dose and rate of rtPA were at physician discretion to a maximum of 48 h	Mean 8 mo (range: 1.5-20.5 mo)

Abbreviations: CDT, catheter-directed thrombolysis; MT, mechanical thrombectomy; PCDT, pharmacomechanical catheter-directed thrombolysis; PMT, pharmacomechanical MT; rtPA, recombinant tPA; tPA, tissue plasminogen activator; UAT, ultrasound-accelerated thrombolysis.

The population is included in this analysis because while mixed, it is largely arterial.

Study also reported on patients with subacute occlusions, defined as 14-42 days, which is beyond our inclusion criteria and therefore excluded from scope of this review.

Study included an additional 92 patients with venous thrombosis, which we excluded from our review on arterial population