The Use of AngioJet in Arterial, Venous, and Fistula Occlusion

Purpose: AngioJet is a versatile mechanical thrombectomy device that has a role in acute vascular presentations. In our department, we use it for venous disease, fistula salvage, and acute arterial occlusions. We hypothesize that its utility results in favorable perioperative outcomes and lower hospital costs.
Materials and Methods: A retrospective review of all patients in whom the Angiojet was used for the previous 3 years was conducted. The outcomes of interest included major complications, reintervention rates, and length of stay (LOS). Cost analysis based on median LOS was calculated. Subgroup analysis based on indication was performed.
Results: We identified 100 procedures in 95 patients. Of these, 93% had technical success. The median LOS was 6 days. The perioperative complication rate was 8%, and the 6-month reintervention rate was 19%. For acute lower limb occlusion, 70 procedures were performed in 65 patients. Of these, 94% had technical success. A complication rate of 10% was observed; of these, 85% were reversible kidney injury. The median LOS was 7 days, and the reintervention rate was 17% (n = 12) in 6 months. Progression to a major amputation was 12.8%. For fistula salvage, 17 procedures were performed on 16 thrombosed fistulas. Of these, 13 were radiocephalic and 3 brachiocephalic. Technical success and the ability to use the fistula immediately for hemodialysis were achieved in all cases. Concurrent plasty was needed in 100%
and stenting in 38% of cases. The 6-month reintervention rate was 31%. No complications were encountered.
Conclusions: AngioJet allows for minimally invasive intervention with a high technical success rate and short LOS.