ISSN 2149-2263 | E-ISSN 2149-2271
pdf
Is it Time to Reappraise for Black-Box Warning on AngioJet Rheolytic Thrombectomy in Patients with Pulmonary Embolism: A Systematic Review and Meta-analysis [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-30584 | DOI: 10.14744/AnatolJCardiol.2024.4081

Is it Time to Reappraise for Black-Box Warning on AngioJet Rheolytic Thrombectomy in Patients with Pulmonary Embolism: A Systematic Review and Meta-analysis

Cihangir Kaymaz1, Barkın Kültürsay1, Hacer Ceren Tokgöz1, Aykun Hakgör2, Berhan Keskin3, Özgür Yaşar  Akbal1, Ayhan Tosun1, Seda Tanyeri1, Ahmet Sekban1, Çağdaş Buluş1, Şeyhmus Külahçıoğlu1, Ali Karagöz1, İbrahim Halil  Tanboğa4, Nihal Özdemir1
1Department of Cardiology, Kartal Koşuyolu Training and Research Hospital, İstanbul, Türkiye
2Department of Cardiology, Faculty of Medicine, Medipol University, İstanbul, Türkiye
3Department of Cardiology, Kocaeli City Hospital, Kocaeli, Türkiye
4Department of Cardiology, Hisar Intercontinental Hospital, Nişantaşı University, İstanbul, Türkiye

Background: AngioJet rheolytic thrombectomy (ART) system has been widely used as a catheter-directed treatment (CDT) method in acute pulmonary embolism (PE), however, there has been a controversy regarding the safety of its use. In this systematic review and meta-analysis, we evaluated the efficacy and safety outcomes of ART in patients with PE.

Methods: Our meta-analysis have been based on search in the MEDLINE, EMBASE, and Cochrane Library for studies published up to August 2022. The primary outcomes were overall pooled rates of major bleeding (MB) and minor bleeding (mB), worsening renal function (WRF), bradycardia/conduction disturbance (BCD), and PE-related and all-cause mortality in patients who underwent ART.

Results: Among the 233 studies documented at initial search, 24 studies were eligible for meta-analysis, and a total of 427 PE patients who underwent ART were evaluated. Overall pooled rates of MB and mB were 9.6% (95% CI 5.9%-15.2%) and 9.2% (95% CI 6.1%-13.6%), transient BCD and WRF were 18.2% (95% CI 12.4%-26%) and 15% (95% CI 10%-21.8%), and PE-related death and all-cause death were 12.7% (95% CI 9.1%-17.3%) and 15% (95% CI 11%-20%), respectively. However, significant heterogeneity and some evidence of funnel plot asymmetry and publication bias were noted for MB, BCD and WRF, but not for PE-related death and all-cause death.

Conclusion: Overall pooled rates of bleeding events, BCD and WRF episodes, PE-related death and all-cause death may be considered as encouraging results for efficacy and safety issues of ART utilization in specific scenarios of acute PE, and a reappraisal for black-box warning on ART seems to be necessary.

Keywords: Angiojet rheolytic thrombectomy, catheter-directed thrombolysis, pulmonary embolism



Corresponding Author: Cihangir Kaymaz, Türkiye
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

Quick Search



Copyright © 2024 The Anatolian Journal of Cardiology



Kare Publishing is a subsidiary of Kare Media.