Factors related to acute kidney injury after AngioJet rheolytic thrombectomy

Acta Radiol. 2024 Nov 18:2841851241292810. doi: 10.1177/02841851241292810. Online ahead of print.

Abstract

Background: AngioJet rheolytic thrombectomy is associated with a higher risk of acute kidney injury due to its potential for inducing mechanical harm and intravascular hemolysis. However, previous studies have focused on a single disease entity.

Purpose: To identify predictors associated with acute kidney injury after AngioJet rheolytic thrombectomy across a range of disease entities.

Material and methods: A total of 95 patients who underwent AngioJet rheolytic thrombectomy between October 2018 and April 2023 were retrospectively reviewed. In total, 11 patients were excluded due to the absence of a postprocedural serum creatinine test within 72 h; finally, 84 patients were included. Acute kidney injury was defined as a ≥1.5-fold increase or ≥0.3 mg/dL rise in serum creatinine within 72 h after the procedure. Univariate and multivariate analysis were performed to identify risk factors for acute kidney injury.

Results: Technical and clinical success were achieved in all patients (84/84, 100%). Of the 84 patients (40 men [47.6%], 44 women [52.4%]; mean age = 67.2 ± 15.9 years), 15 (17.8%) had developed acute kidney injury. Multivariate analysis showed concurrent malignancy (odds ratio [OR] = 42.231, 95% confidence interval [CI] = 2.332-764.693; P = 0.011) and AngioJet rheolytic thrombectomy in arterial system (OR = 24.109, 95% CI = 1.319-440.551; P = 0.032) as statistically significant predictors of acute kidney injury.

Conclusions: AngioJet rheolytic thrombectomy is a potential risk for acute kidney injury. Concurrent malignancy and AngioJet rheolytic thrombectomy in the arterial system are independent predictors of acute kidney injury.

Keywords: Acute kidney injury; AngioJet; pharmacomechanical thrombectomy; rheolytic thrombectomy.