Table 4:
Limb Salvage Rates With Mechanical Thrombectomy Use in Arterial Acute Limb Ischemia
| Results | ||||
|---|---|---|---|---|
| Author, year | Outcome measurement | MT | Comparator | P value |
|
PMT
(AngioJet) | ||||
| de Athayde Soares et al, 202077 | Limb salvage rate at 720 d post-procedure (2 y) | 89.7% (n = 16) | 87.8% (n = 27) | Kaplan-Meier curve: P = .784 |
| Multivariate Cox regression analysis of factors associated with limb salvage rate | Rutherford classification, gender, kidney disease, diabetes, segment occluded, fasciotomy, type of surgery | None were significant P > .05 | ||
| Escobar et al, 201778 | Major amputation | 3% (n = 1) | 5% (n = 2) | NR |
| Gandhi et al, 201879 | Amputation | 14.8% (n = 8) | 20.7% (n = 6) | P = .55 |
| Limb salvage up to 60 mo | 85% (n = 46) | 79% (n = 23) | P = .55 | |
| Amputation free survival, median | 4.2 y (range: 3.0-5.9 y) |
4.6 y (range: 3.2-5.7 y) |
P = .91 | |
| Gong et al, 20211 Included large bore catheters, AngioJet, and Rotarex | Limb salvage at 6 mo | 93.0% (n = 53) | 90.2% (n = 37) | P = .625 |
| Limb salvage at 12 mo | 89.5% (n = 51) | 82.9% (n = 34) | P = .346 | |
| Muli Jogi et al, 201882 Included both AngioJet and Rotarex |
Major amputation at 30 d | 7.1% (n = 2) | 16.9% (n = 15) | P = .323 |
| Minor amputation at 30 d | 3.6% (n = 1) | 1.1% (n = 1) | NR | |
|
Vacuum
Aspiration (Indigo) | ||||
| No studies met our inclusion criteria for this mechanical thrombectomy device | ||||
|
Rotational
(Rotarex) | ||||
| Gong et al, 2021,1 included large bore catheters, AngioJet, and Rotarex (findings discussed elsewhere in this assessment)a | ||||
| Hundt et al, 201380 | Amputations | 0 | 0 | NR |
| Kronlage et al, 201781 | Amputation-free survival among non-critically ill, at 12 mo | NRb | NRb | Kaplan-Meier curve: P = .21 |
| Amputation-free survival among critically ill, at 12 mo | NRb | NRb | Kaplan-Meier curve: P = .14 |
|
| Muli Jogi et al, 2018,82 included both AngioJet and Rotarex (findings discussed elsewhere in this assessment)c | ||||
| Puangpunngam et al, 202083 | Limb salvage at 1 mo | 100% (n = 12) | 94.7% (n = 21) | P = .65 |
| Limb salvage at 3 mo | 80% (n = 9) | 80% (n = 17) | P = .751 | |
|
Ultrasound
Assisted (EKOS) | ||||
| Chait et al, 201974d | Major limb loss | 9% (n = 2) | 14% (n = 10) | P = .46 |
| Schernthaner et al, 201484 | Amputation | 1.3% (n = 1) | 0 | NR |
Abbreviations: ABI, ankle-brachial index; MT, mechanical thrombectomy; NR, not reported; PMT, pharmacomechanical thrombectomy.
a
Gong et al1 compared treatment groups of large bore catheters versus AngioJet versus Rotarex.
b
Data presented as Kaplan-Meier curves, specific details not obtainable.
c
Muli Jogi et al, 201882 compared catheter-directed thrombolysis versus AngioJet and Rotarex.
d
While all patients in both groups also received AngioJet, the study design isolated the effect of EKOS.