Mid-term follow-up after percutaneous hydrodynamic thrombectomy in lower limb ischemia: Initial experience with two-dimensional MR imaging and three-dimensional MR angiography

PURPOSE: To assess noninvasively mid-term patency, reocclusion, and mid-ter m changes of the arterial wall after percutaneous hydrodynamic thrombectomy in patients with acute lower limb ischemia using magnetic resonance (MR) i maging/MR angiography (MRA), MATERIALS AND METHODS: Arterial wall and luminal changes were evaluated in 16 patients (10 men, six women; mean age, 70 years), with a minimum follow- up of 12 months after percutaneous thrombectomy with a hydrodynamic cathete r for acute lower limb ischemia (embolic, n = 6; thrombotic, n = 11), Adjun ctive PTA was performed in 44%. The mean follow-up was 23 months +/- 7.6 (r ange, 12-33 months), MR imaging and MRA were performed on a 1.0 T system us ing an extremity coil and two-dimensional (2D) time-of-flight, turbo spin e cho, 2D gradient echo, and contrast enhanced three-dimensional (3D) gradien t echo sequences, RESULTS: In one patient, a complete reocclusion was noted and, in two patie nts, a hemodynamically insignificant restenosis (less than or equal to 50%) was identified with MR imaging. This was in accordance with color flow dup lex sonography, physical examination, ankle/brachial index measurements, an d the treadmill test, The MR morphometry documented an increase of the enti re vessel area from 48.9 mm(2) +/- 3.3 (control segments) to 55.5 mm(2) +/- 2.8 at the treated segments (+13.3%; P < .05), The vessel wall area increa sed from 31.7 mm(2) +/- 1.8 to 39.4 mm(2) +/- 2.3 (+24.4%; P < .05), The me an area stenosis grade was 12%, CONCLUSION: MR imaging with use of morphometric analysis is a possible tool to noninvasively determine the mid-term patency and restenosis/reocclusion and remodeling process after percutaneous thrombectomy and other intervent ional procedures.