AngioJetTM Rheolytic Thrombectomy and Acute Kidney Injury Understanding the Risks

Introduction:
AngioJetTM rheolytic thrombectomy is widely used for treating deep vein thrombosis (DVT) to reduce post-thrombotic syndrome risk. However, recent findings suggest its potential to induce intravascular haemolysis, leading to acute kidney injury (AKI). A case study published in the Journal of Clinical Nephrology highlights a 37-year-old patient who developed dialysis-requiring AKI following AngioJetTM thrombectomy.

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Understanding the Case Study:
A previously healthy 37-year-old male developed progressive right upper limb swelling, later diagnosed as upper limb DVT associated with thoracic outlet syndrome. He underwent AngioJetTM thrombectomy followed by IV heparin infusion, achieving successful vein revascularization. However, within 24 hours, he exhibited haematuria and signs of AKI.

Key clinical observations:

• Significant rise in creatinine levels (peaking at 1070 umol/L within 96 hours).
• Confirmed intravascular haemolysis (elevated LDH, low haptoglobin, and absence of red blood cells in urinalysis).
• Need for dialysis over six days before gradual kidney function recovery over three months.

Implications for Clinical Practice:
The American College of Radiology (ACR) emphasizes maintaining high standards of radiological care while ensuring patient safety. This case underscores the need for:

• Early identification of intravascular haemolysis post-thrombectomy.
• Careful monitoring of renal function in patients undergoing mechanical thrombectomy.
• Risk stratification for AKI, especially in high-risk individuals.

Key Takeaways:

• AngioJetTM thrombectomy can induce haemolysis, potentially leading to severe AKI.
• Monitoring for haemoglobinuria and renal impairment is critical post-procedure.
• Clinicians should weigh the benefits of thrombectomy against its renal risks.

For a more in-depth analysis, read the full study at https://doi.com/10.29328/journal.jcn.1001015.

Final Thoughts:
As mechanical thrombectomy technology advances, awareness of its complications is crucial for optimal patient care. To stay updated on the latest nephrology research, explore more studies at HSPIOA and share your thoughts in the comments below!

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