Rheolytic thrombectomy with the Possis AngioJet (R): Technical considerations and initial clinical experience

Percutaneous revascularization of thrombus-containing lesions has an increa sed incidence of adverse events such as abrupt vessel closure, periprocedur al myocardial infarction and death. Various pharmacologic and mechanical ap proaches have demonstrated modest angiographic success with significant per iprocedural complications. The AngioJet(R) (Possis Medical, Inc., Minneapol is, Minnesota) is a dual lumen catheter that uses the principle of rheolyti c thrombectomy to remove unorganized thrombus. A previously unreported scor ing system based on clinical and angiographic data may help to select patie nts most likely to benefit from AngioJet treatment. When compared with urok inase in the randomized VeGAS 2 Trial, AngioJet therapy yields greater angi ographic success with a lower incidence of 30-day major adverse events. Tec hnical considerations and complications are reviewed in detail.