Abstract
BackgroundPercutaneous mechanical thrombectomy (PMT) is a well-established technique for treatment of acute arterial and venous thrombosis which inevitably leads to intravascular erythrocyte hemolysis, resulting in hemoglobinuria.Case presentationWe present a case of 66-year-old Caucasian female with subclavian artery aneurysm causing distal embolization and hand ischemia. The aneurysm was treated with stent graft, but with a subsequent graft thrombosis 3 months later. After graft recanalisation, AngioJet PMT was performed which resulted in dialysis-requiring acute kidney injury.ConslusionOnly several cases of acute kidney injury following AngioJet PMT have been published in literature. To our knowledge, this is the first reported case of dialysis-requiring AKI after PMT for peripheral arterial thrombosis. Until there is sufficient evidence and recommendation on preventing AKI in this setting, we believe that by being aware of the risk and by monitoring of patient, one might minimize the damage in case it occurs.
Highlights
Percutaneous mechanical thrombectomy (PMT) is a well-established technique for treatment of acute arterial and venous thrombosis which inevitably leads to intravascular erythrocyte hemolysis, resulting in hemoglobinuria
Case presentation: We present a case of 66-year-old Caucasian female with subclavian artery aneurysm causing distal embolization and hand ischemia
We found no published cases reporting acute kidney injury (AKI) after AngioJet PMT for peripheral arterial thrombosis
Summary
Percutaneous mechanical thrombectomy (PMT) is a well-established technique for treatment of acute thrombosis. The AngioJet system (Boston Scientific, USA) uses high-velocity saline jets to fragment and aspirate thrombus. This inevitably leads to intravascular hemolysis, resulting in hemoglobinuria. Several cases of acute kidney injury (AKI) following AngioJet PMT have been published. Case presentation A 66-year-old Caucasian female was referred for evaluation of subclavian artery aneurysm causing distal embolization and hand ischemia. Her medical history was notable of hypertension and hyperlipidemia without notice of renal insufficiency. AngioJet PMT was performed after thrombus lacing with 10 mg of t-PA, with a total aspiration time of 180 s (Fig. 2).
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