PEARL registry results suggest rheolytic thrombectomy combined with adjunctive therapy is safe and effective for the treatment of deep vein thrombosis

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The results of PEARL (Registry of AngioJet use in the peripheral vascular system), a phase II multicentre registry, led by Robert Lookstein, chief of interventional radiology, Mount Sinai Medical Center, New York, USA, have suggested that rheolytic pharmacomechanical thrombectomy using combination therapy is fast and effective and can reduce treatment time for deep vein thrombosis from more than two days to less than 24 hours according to data presented at the Annual International Symposium on Endovascular Therapy (ISET).

The combination treatment involved giving deep vein thrombosis patients an intravenous catheter to introduce clot-busting drugs and then blasting the clot with high-pressure saline solution to break it up. A separate port on the catheter then vacuums up pieces of the clot and removes them from the body.

In the study, 371 deep vein thrombosis patients were treated at 35 centres; 38% of treatments were completed in less than six hours and 76% in less than 24 hours. After 12 months, 81% of patients remained free of deep vein thrombosis. Stents were placed in 116 patients (most in the pelvic arteries) to correct obstructions and prevent the future formation of clots.

The Medad Angiojet Catheter (Bayer) was used in conjunction with the Power Pulse Spray technique and the Rapid Lysis technique in 86% of cases. Ninety-five percent of the treated vessels substantial or complete lysis was achieved and freedom from rethrombosis rates were 94% at three months, 86% at six months, and 81% at 12 months.

“Rheolytic thrombectomy combined with adjunctive therapies form a safe and effective strategy of endovascular treatment for deep vein thrombosis,” Lookstein said.

“We are on the verge of a truly outpatient procedure for the treatment of deep vein thrombosis,” added Lookstein. “This is a transformative technology that will enable more people who are suffering from deep vein thrombosis to have fast, effective minimally invasive therapy.”

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