Aspiration Thrombectomy with the Indigo System for Acute Lower Limb Ischemia: Preliminary experience and analysis of parameters affecting the outcome.

Autor:	Rossi M; Department of Surgical and Medical Sciences and Translational Medicine, Sapienza - University of Rome, Rome, Italy., Tipaldi MA; Department of Surgical and Medical Sciences and Translational Medicine, Sapienza - University of Rome, Rome, Italy. Electronic address: tipaldi.andrea@gmail.com., Tagliaferro FB; Department of Radiology and Interventional Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy., Pisano A; Department of Radiology and Interventional Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy., Ronconi E; Department of Radiology and Interventional Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy., Lucertini E; Department of Radiology and Interventional Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy., Daffina J; Department of Radiology and Interventional Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy., Caruso D; Department of Radiological Sciences, Oncological and Pathological Sciences, Sapienza- Sant'Andrea University Hospital, University of Rome, Rome, Italy., Laghi A; Department of Surgical and Medical Sciences and Translational Medicine, Sapienza - University of Rome, Rome, Italy., Laurino F; Department of Radiology and Interventional Radiology, Sant'Andrea University Hospital La Sapienza, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2021 Oct; Vol. 76, pp. 426-435. Date of Electronic Publication: 2021 May 02.
DOI:	10.1016/j.avsg.2021.04.016
Abstrakt:	Background: The purpose of our study is to assess the short-term technical success and the safety of the Indigo System in a series of patients undergoing vacuum-assisted catheter direct thrombus aspiration (IS-CDTA) for acute lower limb ischemia (ALLI) and to evaluate which parameters may affect the outcome. Methods: All procedures using the IS-CDTA for ALLI, performed in a single-centre Interventional Radiology Unit from February 2016 to March 2020, were retrospectively analysed. Technical success was defined as the achievement of nearly-complete or complete revascularization (TIPI grade 2/3) and considered as a good outcome. Variables potentially correlated with the IS-CDTA outcome were analysed. Results: 33 procedures were performed in 29 patients. Mean age was 69 years old (range 47 - 88), 24 males (83%) and 5 females (18%). The technical success was 70%. Catheter-directed thrombolysis following IS-CDTA was performed in 23 cases and the overall technical success increased from 70% to 90%, afterwards. The median time between symptoms insurgency and IS-CDTA was significantly shorter in patients with good outcome (10 hours; IQR 2.75-48) compared to those with poor outcome (168 hours; IQR 36-336) (P = 0.003). No statistically significant differences were found between the two groups regarding ATK vs. BTK (P = 0.34), native vessel vs. graft (P = 0.25), occlusion nature P = 0.28) or Rutherford score (P = 0.80). Conclusion: IS-CDTA is a valid option for a rapid and percutaneous treatment of ALLI. Our experience indicates that the time elapsing from the symptoms insurgency and the endovascular procedure is the best positive predictor of the outcome. (Copyright © 2021. Published by Elsevier Inc.)
Databáze:	MEDLINE
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