Table 5:
Technical Success With Mechanical Thrombectomy Use in Arterial Acute Limb Ischemia
| Results | ||||
|---|---|---|---|---|
| Author, year | Outcome measurement | MT | Comparator | P value |
| PMT (AngioJet) | ||||
| Byrne et al, 201476 | Proportion of patients who achieved restoration of blood flow to the foot, and to what was believed to be the baseline flow | 90.1% (n = 64) | 78.3% (n = 65) | P = .047 |
| de Athayde Soares et al, 202077 | Proportion of patients with no more than 30% residual stenosis and restoration of blood flow | 81.6% (n = 15) | 77.7% (n = 24) | P = .45 |
| Gandhi et al, 201879 | Technical success | 87% (n = 47) | 89% (n = 26) | P = 1.00 |
| Gong et al, 20211 Included large bore catheters, AngioJet and Rotarex | Technical success among patients who had adjuvant thrombolysis | 100% (n = 57) | 100% (n = 41) | P = 1.000 |
| Technical success among patients who had adjunctive stents or angioplasty after removal | 82.5% (n = 47) | 80.5% (n = 33) | P = .804 | |
| Muli Jogi et al, 201882 Included both AngioJet and Rotarex |
Technical success | 67.9% (n = 19) | 47.2% (n = 42) | P = .056 |
| 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 | ||||
| Hundt et al, 201380 | TIMI scoresa | 1,625 | 1,121 | P < .0001 |
| Overall total scores | ||||
| Immediately after procedure | 133 | 0 | P < .0001 | |
| At 24 h | 342 | 136 | P < .0001 | |
| At 48 h | 550 | 396 | P < .0001 | |
| At 72 h | 600 | 588 | NS | |
| Muli Jogi et al, 2018,82 included both AngioJet and Rotarex (see findings discussed elsewhere in this assessment)b | ||||
| Technical success | 100% (n = 12) | 85.7% (n = 19) | P = .268 | |
| Puangpunngam et al, 202083 | Complete clot removal | 87.1% (n = 10) | 57.1% (n = 13) | P = .2 |
| Ultrasound Assisted (EKOS) | ||||
| Chait et al, 201974,c | Proportion of patients who achieved complete, or near complete, resolution of thrombus burden | 86% (n = 19) | 72% (n = 52) | P = .31 |
| Schernthaner et al, 201484 | Technical success | 100% (n = 75) | 100% (n = 27) | NS |
| Proportion with complete angiographic success | 72.0% (n = 54) | 63.0% (n = 17) | P = .542 | |
Abbreviations: NS, not significant; MT, mechanical thrombectomy; PMT, pharmacomechanical thrombectomy; TIMI, thrombosis in myocardial infarction.
a
A classification system borrowed from coronary perfusion assessments where 0 is complete blockage and 3 is the highest score of complete reperfusion achieved.
b
Muli Jogi et al, 201882 compared catheter-directed thrombolysis versus AngioJet and Rotarex.
c
While all patients in both groups also received AngioJet, study design was to isolate the effect of EKOS.