Table 6:
Patency With Mechanical Thrombectomy Use in Arterial Acute Limb Ischemia
| Author, year | Outcome measurement | Results | P value | |
|---|---|---|---|---|
| MT | Comparator | |||
| PMT (AngioJet) | ||||
| Byrne et al, 201476 | Primary patency at: | |||
| 12 mo | 59% (n = 42) | 54% (n = 45) | Kaplan-Meier curve P = .524 | |
| 24 mo | 50% (n = 36) | 41% (n = 34) | ||
| Multivariate analysis of primary patency, PMT use | HR 0.85; 95% CI: 0.52-1.40 | P = .525 | ||
| Primary assisted patency at: | ||||
| 12 mo | 70% (n = 50) | 62% (n = 51) | Kaplan-Meier curve P = .288 | |
| 24 mo | 60% (n = 42) | 50% (n = 42) | ||
| Secondary patency at: 12 mo 24 mo | ||||
| 12 mo | 87% (n = 62) | 74% (n = 61) | Kaplan-Meier curve P = .197 | |
| 24 mo | 80% (n = 57) | 62% (n = 51) | ||
| de Athayde Soares et al, 202077 | Ankle-brachial index postoperativea | .9 | .87 | P = .14 |
| Secondary patency | 81.9% (n = 15) | 78.8% (n = 24) | Kaplan-Meier curve P = .664 | |
| Gandhi et al, 201879 | Primary patency, 30 d | 72.2% (n = 39) | 75.9% (n = 22) | P = .92 |
| Primary patency at 1 y | 40.7% (n = 22) | 48.3% (n = 14) | P = 79 | |
| Long-term primary patency | Mean follow up 480 d: 33.3% (n = 18) | Mean follow up 728 d: 24.1% (n = 7) | P = .54 | |
| Gong et al, 20211 Included large bore catheters, AngioJet, and Rotarex | Ankle-brachial index at treatment completiona | .72 (SD ± 0.16) | .66 (SD ± 0.13) | P = .101 |
| Muli Jogi et al, 201882 Included both AngioJet and Rotarex | Clinical success defined as return to premorbid Rutherford score without amputation by 30 d | 75% (n = 21) | 73% (n = 65) | P = .837 |
| 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 | Ankle-brachial indexa | |||
| At 24 h | Acute: 0.63 (SD ± 0.14) Subacute: 0.43 (SD ± 0.08) | Acute: 0.51 (SD ± 0.11) Subacute: 0.41 (SD ± 0.04) | Acute: P = .0001 Subacute: P = .2080 | |
| At 48 h | Acute: 0.79 (SD ± 0.04) Subacute: 0.67 (SD ± 0.14) | Acute: 0.69 (SD ± 0.14) Subacute: 0.55 (SD ± 0.09) | Acute: P = .0001 Subacute: P = .0001 | |
| At 72 h | Acute: 0.81 (SD ± 0.03) Subacute: 0.79 (SD ± 0.02) | Acute: 0.79 (SD ± 0.02) Subacute: 0.79 (SD ± 0.06) | Acute: P = .0010 Subacute: P = 1.0 | |
| Kronlage et al, 201781 | Primary patency, up to 12 mo | Higher patency among patients who received MT alone compared to those who received lysis, or combined MT + lysis | Kaplan-Meier curve P < .0001 | |
| Secondary patency, up to 12 mo | Greatest in the MT alone group (85%) compared to the lysis alone or combined MT + lysis groups | Kaplan-Meier curve P < .05 | ||
| Ankle-brachial index, up to 12 moa | MT alone: 0.87 (SD ± 0.23) MT + lysis: 0.88 (SD ± 0.28) | 0.71 (SD ±0.31) | P > .05 | |
| Muli Jogi et al, 2018,82 included both AngioJet and Rotarex (findings discussed elsewhere in this assessment)b | ||||
| Ultrasound Assisted (EKOS) | ||||
| Schernthaner et al, 201484 | Proportion with patency achieved at last follow up (mean 8 mo) | 75.9% (n = 41) | 64.3% (n = 9) | P = 379 |
| Media ankle-brachial indexa | .96 (IQR: 0.72, 1.07) | .84 (IQR: 0.79, 1.000 | P = .572 | |
| Hemodynamic success by .1 ankle-brachial index | 95.9% (n = 47) | 92.3% (n = 12) | P = .590 | |
Abbreviations: CI, confidence interval; HR, hazard ratio; IQR, interquartile index; MT, mechanical thrombectomy; PMT, pharmacomechanical thrombectomy; SD, standard deviation.
a
Baseline values were similar between groups.
b
Muli Jogi et al, 201882 compared catheter-directed thrombolysis versus AngioJet and Rotarex.