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 J.
AU - Soukas, Peter A.
N1 - Funding Information:
Funding for the PEARL registry data collection, monitoring, statistical analysis, and medical writing was provided by Boston Scientific. The principal institutions and investigators participating in the PEARL registry are as follows: St Luke’s Medical Center (Mark Mewissen, MD), Charleston Area Medical Center (Aravinda Nanjundappa, MD, and Laura Findeiss, MD), Chilton Memorial Hospital (Lawrence Blitz, MD), Chris Recknor, MD, PC (Michael Lebow, MD), Christiana Care Medical Center (Mark Garcia, MD), Cleveland Clinic (Sean Lyden, MD), Coastal Vascular & Interventional (Christopher Bosarge, MD), CorVasc MDs (Jeffrey Cooke, MD), CV Institute of the South (Raghotham Patlola, MD), Duke University (Michael Miller, MD), First Coast Cardiovascular Institute (Yazan Khatib, MD), Forsyth Medical Center (Stephen Motew, MD), Good Samaritan Hospital Dayton (Kian Mostafavi, MD [phase 2], Eugene Simoni, MD [phase 1]), Good Samaritan Hospital Los Angeles (Guy Mayeda, MD), Grant Medical Center (Randall Franz, MD), Great Lakes Heart & Vascular Institute (Thomas Pow, MD), Holston Valley Medical Center (D. Christopher Metzger, MD), Indiana University Health Arnett (Katherine Krol, MD), John C. Lincoln Deer Valley Hospital (Aaron Wittenberg, MD), John Muir Health Center (David Goldberg, MD), Medical University of South Carolina (Marcelo Guimaraes, MD), Mills–Peninsula Health Services (John Rosenman, MD), Mount Sinai School of Medicine (Aaron Fischman, MD [PII], Joshua Weintraub, MD [principal investigator]), Naples University Federico II (Giovanni Esposito, MD), National Institute CV Diseases (Ivan Vulev, MD), North Central Heart Institute (J. Michael Bacharach, MD), Peninsula Cardiology Associates, PA (Benjamin Meyer, MD), Phoenix Heart (Rahul Malhotra, MD), Prairie Heart Institute (Gregory Mishkel, MD), Shady Grove Adventist Hospital (Jeffrey Wang, MD), University of Florida Health Shands Hospital (Jerry Matteo, MD), St Luke’s Hospital & Health Network (Michael Ringold, MD), St. Vincent Medical Centers of New York (Thomas Bernik, MD), Stony Brook University (Antonios Gasparis, MD), Städtisches Klinikum Karlsrühe (Peter Reimer, MD), Southwest Washington Medical Center (Riyad Karmy-Jones, MD), Terrebonne General Medical Center (Craig Walker, MD), The Miriam Hospital (Peter Souka, MD), The Reading Hospital & Medical Center (Ali Amin, MD), University of Tennessee–Chattanooga (Christopher LeSar, MD), University of Tennessee–Knoxville (Scott Stevens, MD), University of Toledo (Munier Nazzal, MD), University of Virginia Health System (John Angle, MD), Willis Knighton Bossier Health Center (Britton Eaves, MD), and Winchester Medical Center (Preston Fox, MD).
Publisher Copyright:
© 2015 SIR.
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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U2 - 10.1016/j.jvir.2015.01.036
DO - 10.1016/j.jvir.2015.01.036
M3 - Article
C2 - 25824314
AN - SCOPUS:84930381761
SN - 1051-0443
VL - 26
SP - 777
EP - 785
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 6
ER -