Comparison of the short-term and long-term effects of AngioJet and AcoStream mechanical catheter thrombolysis on acute iliofemoral vein thrombosis.

Abstract

Objective: To compare the short-term and long-term clinical efficacy and safety of AngioJet and AcoStream thrombectomy devices in the treatment of acute iliofemoral venous thrombosis.

Methods: We conducted a 4-year retrospective case ‒ control study. A total of 243 patients with acute iliofemoral deep vein thrombosis underwent endovascular interventional therapy in our hospital. According to different operation methods, patients were divided into two groups: Group A (AngioJet mechanical thrombectomy system) and Group B (AcoStream mechanical thrombectomy system). The clinical basic data and short-term postoperative efficacy of the two groups were compared. After 36-months of follow-up, the recurrence rate and long-term efficacy of post-thrombotic syndrome were compared between the two groups. The Kaplan-Meier survival method was used to analyze the proportion of Post-Thrombotic Syndrome (PTS).

Results: The thrombus aspiration time in the AngioJet group (4.62 ± 0.12 min) was shorter than that in the AcoStream group (5.87 ± 0.09 min) (p = 0.001); the intraoperative blood loss (264.12 ± 5.46 mL) was less than that in the AcoStream group (307.62 ± 4.52 mL) (p < 0.001); the hemoglobin difference (15.57 ± 0.72 g/L) was less than that in the AcoStream group (24.58 ± 0.86 g/L) (p < 0.001); the D - D decrease rate (0.85 ± 0.03 mg/L/D) was faster than that in the AcoStream group (0.75 ± 0.03 mg/L/D) (p = 0.03); the dosage of urokinase (147.39 ± 0.71) million units was more than that in the AcoStream group (125.33 ± 1.01) million. Units (p < 0.001). The swelling reduction rates of the thigh and calf at 24-hours after surgery were (0.61 ± 0.01%) vs. (0.56 ± 0.01%) and (0.63 ± 0.01%) vs. (0.66 ± 0.01%), respectively, with statistically significant differences between the two groups (p < 0.05). The incidence of postoperative hematuria in the AngioJet group (91.9%) was higher than that in the AcoStream group (0.0%) (p < 0.001). After 36-months of follow-up, the thrombus recurrence rate in the AngioJet group (8.9%) was compared with that in the AcoStream group (2.5%) (p < 0.05), and the incidence of postoperative PTS in the two groups was (34.95%) vs. (21.67%) (p = 0.016).

Conclusion: Compared with the AcoStream system, the AngioJet system has a higher efficiency of thrombus clearance, but the incidence of hematuria and the recurrence rate are slightly higher. Of course, both have their advantages and disadvantages, and the appropriate surgical method should be selected according to the individual conditions of patients.