Endovascular management of deep vein thrombosis with rheolytic thrombectomy: Final report of the prospective multicenter PEARL (Peripheral use of angiojet rheolytic thrombectomy with a variety of catheter lengths) registry

Mark J. Garcia, Robert Lookstein, Rahul Malhotra, Ali Amin, Lawrence R. Blitz, Daniel A. Leung, Eugene Simoni, Peter A. Soukas

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Abstract

Purpose To report procedural and patient outcomes of endovascular treatment for lower-extremity deep vein thrombosis (DVT) with rheolytic thrombectomy (RT). Materials and Methods A total of 32 sites in the United States and Europe enrolled patients with DVT in the Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths (PEARL) registry. Patient characteristics and outcomes data were collected from consenting patients who underwent rheolytic AngioJet thrombectomy at investigative sites from January 2007 through June 2013. Three hundred twenty-nine patients were enrolled, with 67% of patients undergoing an AngioJet procedure within 14 days of the onset of symptoms. Results Four treatment approaches using AngioJet thrombectomy were identified: RT without lytic agent in 4% of patients (13 of 329), pharmacomechanical catheter-directed thrombolysis (PCDT) in 35% (115 of 329), PCDT and catheter-directed thrombolysis (CDT) in 52% (172 of 329), and RT in combination with CDT in 9% (29 of 329). Median procedure times for RT alone, PCDT, PCDT/CDT, and RT/CDT were 1.4, 2, 22, and 41 hours, respectively (P <.05, Kruskal-Wallis test). Procedures were completed in less than 24 hours for 73% of patients, with 36% of procedures completed within 6 hours; 86% of procedures required no more than 2 catheter laboratory sessions. The 3-, 6-, and 12-month freedom from rethrombosis rates were 94%, 87%, and 83%, respectively. Major bleeding events occurred in 12 patients (3.6%), but none were related to the AngioJet procedure. Conclusions PEARL registry data demonstrate that rheolytic PCDT treatment of DVT is safe and effective, and can potentially reduce the need for concomitant CDT and intensive care.

Original languageEnglish (US)
Pages (from-to)777-785
Number of pages9
JournalJournal of Vascular and Interventional Radiology
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2015

Fingerprint

Thrombectomy
Venous Thrombosis
Registries
Catheters
Critical Care
Lower Extremity

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

@article{75367073f38c4e0fa109539bf3830688,
title = "Endovascular management of deep vein thrombosis with rheolytic thrombectomy: Final report of the prospective multicenter PEARL (Peripheral use of angiojet rheolytic thrombectomy with a variety of catheter lengths) registry",
abstract = "Purpose To report procedural and patient outcomes of endovascular treatment for lower-extremity deep vein thrombosis (DVT) with rheolytic thrombectomy (RT). Materials and Methods A total of 32 sites in the United States and Europe enrolled patients with DVT in the Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths (PEARL) registry. Patient characteristics and outcomes data were collected from consenting patients who underwent rheolytic AngioJet thrombectomy at investigative sites from January 2007 through June 2013. Three hundred twenty-nine patients were enrolled, with 67{\%} of patients undergoing an AngioJet procedure within 14 days of the onset of symptoms. Results Four treatment approaches using AngioJet thrombectomy were identified: RT without lytic agent in 4{\%} of patients (13 of 329), pharmacomechanical catheter-directed thrombolysis (PCDT) in 35{\%} (115 of 329), PCDT and catheter-directed thrombolysis (CDT) in 52{\%} (172 of 329), and RT in combination with CDT in 9{\%} (29 of 329). Median procedure times for RT alone, PCDT, PCDT/CDT, and RT/CDT were 1.4, 2, 22, and 41 hours, respectively (P <.05, Kruskal-Wallis test). Procedures were completed in less than 24 hours for 73{\%} of patients, with 36{\%} of procedures completed within 6 hours; 86{\%} of procedures required no more than 2 catheter laboratory sessions. The 3-, 6-, and 12-month freedom from rethrombosis rates were 94{\%}, 87{\%}, and 83{\%}, respectively. Major bleeding events occurred in 12 patients (3.6{\%}), but none were related to the AngioJet procedure. Conclusions PEARL registry data demonstrate that rheolytic PCDT treatment of DVT is safe and effective, and can potentially reduce the need for concomitant CDT and intensive care.",
author = "Garcia, {Mark J.} and Robert Lookstein and Rahul Malhotra and Ali Amin and Blitz, {Lawrence R.} and Leung, {Daniel A.} and Eugene Simoni and Soukas, {Peter A.}",
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Endovascular management of deep vein thrombosis with rheolytic thrombectomy : Final report of the prospective multicenter PEARL (Peripheral use of angiojet rheolytic thrombectomy with a variety of catheter lengths) registry. / Garcia, Mark J.; Lookstein, Robert; Malhotra, Rahul; Amin, Ali; Blitz, Lawrence R.; Leung, Daniel A.; Simoni, Eugene; Soukas, Peter A.

In: Journal of Vascular and Interventional Radiology, Vol. 26, No. 6, 01.06.2015, p. 777-785.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endovascular management of deep vein thrombosis with rheolytic thrombectomy

T2 - Final report of the prospective multicenter PEARL (Peripheral use of angiojet rheolytic thrombectomy with a variety of catheter lengths) registry

AU - Garcia, Mark J.

AU - Lookstein, Robert

AU - Malhotra, Rahul

AU - Amin, Ali

AU - Blitz, Lawrence R.

AU - Leung, Daniel A.

AU - Simoni, Eugene

AU - Soukas, Peter A.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Purpose To report procedural and patient outcomes of endovascular treatment for lower-extremity deep vein thrombosis (DVT) with rheolytic thrombectomy (RT). Materials and Methods A total of 32 sites in the United States and Europe enrolled patients with DVT in the Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths (PEARL) registry. Patient characteristics and outcomes data were collected from consenting patients who underwent rheolytic AngioJet thrombectomy at investigative sites from January 2007 through June 2013. Three hundred twenty-nine patients were enrolled, with 67% of patients undergoing an AngioJet procedure within 14 days of the onset of symptoms. Results Four treatment approaches using AngioJet thrombectomy were identified: RT without lytic agent in 4% of patients (13 of 329), pharmacomechanical catheter-directed thrombolysis (PCDT) in 35% (115 of 329), PCDT and catheter-directed thrombolysis (CDT) in 52% (172 of 329), and RT in combination with CDT in 9% (29 of 329). Median procedure times for RT alone, PCDT, PCDT/CDT, and RT/CDT were 1.4, 2, 22, and 41 hours, respectively (P <.05, Kruskal-Wallis test). Procedures were completed in less than 24 hours for 73% of patients, with 36% of procedures completed within 6 hours; 86% of procedures required no more than 2 catheter laboratory sessions. The 3-, 6-, and 12-month freedom from rethrombosis rates were 94%, 87%, and 83%, respectively. Major bleeding events occurred in 12 patients (3.6%), but none were related to the AngioJet procedure. Conclusions PEARL registry data demonstrate that rheolytic PCDT treatment of DVT is safe and effective, and can potentially reduce the need for concomitant CDT and intensive care.

AB - Purpose To report procedural and patient outcomes of endovascular treatment for lower-extremity deep vein thrombosis (DVT) with rheolytic thrombectomy (RT). Materials and Methods A total of 32 sites in the United States and Europe enrolled patients with DVT in the Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths (PEARL) registry. Patient characteristics and outcomes data were collected from consenting patients who underwent rheolytic AngioJet thrombectomy at investigative sites from January 2007 through June 2013. Three hundred twenty-nine patients were enrolled, with 67% of patients undergoing an AngioJet procedure within 14 days of the onset of symptoms. Results Four treatment approaches using AngioJet thrombectomy were identified: RT without lytic agent in 4% of patients (13 of 329), pharmacomechanical catheter-directed thrombolysis (PCDT) in 35% (115 of 329), PCDT and catheter-directed thrombolysis (CDT) in 52% (172 of 329), and RT in combination with CDT in 9% (29 of 329). Median procedure times for RT alone, PCDT, PCDT/CDT, and RT/CDT were 1.4, 2, 22, and 41 hours, respectively (P <.05, Kruskal-Wallis test). Procedures were completed in less than 24 hours for 73% of patients, with 36% of procedures completed within 6 hours; 86% of procedures required no more than 2 catheter laboratory sessions. The 3-, 6-, and 12-month freedom from rethrombosis rates were 94%, 87%, and 83%, respectively. Major bleeding events occurred in 12 patients (3.6%), but none were related to the AngioJet procedure. Conclusions PEARL registry data demonstrate that rheolytic PCDT treatment of DVT is safe and effective, and can potentially reduce the need for concomitant CDT and intensive care.

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