Efficacy, safety, and influencing factors of AngioJet mechanical thrombectomy versus catheter-directed thrombolysis in the treatment of acute lower limb deep vein thrombosis.

OBJECTIVE

This study compared the efficacy and safety of AngioJet mechanical thrombectomy and catheter-directed thrombolysis (CDT) in acute lower limb deep vein thrombosis (DVT), while also assessing predictors of thrombus clearance, patient experience, and economic impact.

METHODS

A retrospective single-center study included 76 patients with acute lower limb DVT treated between January 2017 and January 2022. Patients received either AngioJet (n = 34) or CDT (n = 42). Clinical data included demographics, thrombus characteristics, thrombolysis duration, urokinase dosage, hospital stay, complications, 12-month Villalta scores and satisfaction ratings. Statistical comparisons used chi-square and t-tests; logistic regression identified predictors of grade III thrombus clearance.

RESULTS

AngioJet achieved a significantly higher grade III clearance rate than CDT (70.6% vs. 45.2%, P < 0.05), with shorter thrombolysis duration, lower urokinase use, and reduced hospital stay (all P < 0.05). Puncture site bleeding rates were similar, but hemoglobinuria occurred more frequently with AngioJet (P < 0.01) and resolved after symptomatic care. At 12 months, Villalta scores were comparable, though slightly lower in the AngioJet group, suggesting potential post-thrombotic syndrome prevention. Independent predictors of grade III clearance were AngioJet treatment and symptom onset ≤ 7 days. AngioJet patients reported greater satisfaction with shorter stays and improved recovery.

CONCLUSION

AngioJet mechanical thrombectomy offers superior thrombus clearance, shorter treatment times, and better patient-reported outcomes compared with CDT in acute lower limb DVT. Benefits are greatest in early-stage disease or heavy thrombus burden, supporting its broader clinical application.