Abstract
Background: Since its introduction, percutaneous aspiration embolectomy (PAE) has become a well-known, widely accepted and frequently applied technique for the treatment of acute arterial embolic infrainguinal vascular occlusion in lower limb ischemia. Purpose: To evaluate the technical and clinical success of sole percutaneous aspiration embolectomy (PAE) for the treatment of acute arterial embolic infrainguinal vascular occlusion. Material and Methods: During a period of 7 years, 50 patients (24 fermale, 48%) with a mean age of 73 (range 53–95) years were identified in whom 54 cases of PAE were performed for the treatment of arterial embolic infrainguinal vascular occlusion. Primary technical success was defined as residual stenosis of <50% in diameter after sole PAE, secondary technical success was defined as residual stenosis of <50% in diameter after PAE and additional percutaneous transluminal angioplasty (PTA) and/or stenting. Clinical outcome parameters (e.g. need for further intervention and/or amputation) were evaluated for the 30-day postinterventional period. Results: The primary technical success rate was 85% (46 of 54 cases). The secondary technical success rate was 96% (52 of 54 cases). Clinical outcome data were achievable in 50 of the 54 cases (93%). In 43 of the 50 patients (86%) there was no need for further intervention within the 30-day postinterventional period. In summary, during this 30-day postinterventional period after PAE amputation was carried out or death occurred in 5 of 50 patients (10%). Conclusion: Minimally invasive PAE is an effective and safe technique for the treatment of acute arterial embolic infrainguinal vascular occlusion.
Highlights
Arterial embolism results when a clot of blood migrates through vessels, getting stuck in a distal artery where blood flow is obstructed
Primary technical success was defined as residual stenosis of
In a period of seven years all patients undergoing infrainguinal arterial PAE at a municipal academic teaching hospital were retrospectively identified using the institutional radiologic information system searching for the key words “percutaneous aspiration thrombembolectomy (PAT)”, “percutaneous aspiration embolectomy (PAE)”, “aspiration”, “thrombectomy” and “embolectomy”
Summary
Arterial embolism results when a clot of blood migrates through vessels, getting stuck in a distal artery where blood flow is obstructed This obstruction may lead to ischemia, organ failure and potential infarction. Complications of arterial embolism are multiple and a leading cause of disability and death in developed countries Manifestations of this complex disease include medical and surgical emergencies such as stroke, acute upper or lower limb ischemia as well as mesenteric ischemia or renal failure. Upper and especially lower limb ischemia is one of the most frequent causes of morbidity and mortality from arterial embolic disease. Percutaneous aspiration embolectomy (PAE) has become a well-known, widely accepted and frequently applied technique for the treatment of acute arterial embolic infrainguinal vascular occlusion in lower limb ischemia.
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