Exploration of risk factors for hemoglobinuria and acute kidney injury following iliofemoral venous mechanical thrombectomy  

作　　者：Xinqiang Han Qingqing Zhang Fengfei Xia Yongzhen Zhang Wenming Wang 

机构地区：[1]Department of Interventional Medicine and Vascular,Binzhou Medical University Hospital,Binzhou,256603,Shandong,China [2]Department of Cerebrovascular,Binzhou Medical University Hospital,Binzhou,256603,Shandong,China [3]Department of Interventional Medicine and Vascular,Binzhou Peoples Hospital,Binzhou,256600,Shandong,China

出　　处：《Journal of Interventional Medicine》2023年第1期24-28,共5页介入医学杂志（英文）

基　　金：supported by the Medical and Health Science and Technology Development Plan of Shandong Province, China (Grant No.2017WS688)。

摘　　要：Objective: To evaluate the risk factors for hemoglobinuria and acute kidney injury(AKI) after percutaneous mechanical thrombectomy(MT) with or without catheter-directed thrombolysis(CDT) for iliofemoral deep vein thrombosis(IFDVT).Methods: Patients with IFDVT who had MT with the Angio Jet catheter(group A), MT plus CDT(group B), or CDT alone(group C) from January 2016 to March 2020 were retrospectively evaluated. Hemoglobinuria was monitored throughout the treatment course, and postoperative AKI was assessed by comparing the preoperative(baseline) and postoperative serum creatinine(sCr) levels from the electronic medical records of all patients. AKI was defined as an elevation in the sCr level exceeding 26.5 μmol/L within 72 h after the operation according to the Kidney Disease Improving Global Outcomes criteria.Results: A total of 493 consecutive patients with IFDVT were reviewed, of which 382(mean age, 56 ± 11 years;41% of them were females;97 in group A, 128 in group B, and 157 in group C) were finally analyzed. Macroscopic hemoglobinuria was evident in 44.89% of the patients of the MT groups(101/225, 39 in group A, and 62 in group B), with no significant difference between the groups(P = 0.219), but not in the patients in group C. None of the patients developed AKI(mean sCr difference-2.76 ± 13.80 μmol/L, range =-80.20 to 20.60 μmol/L) within 72h after surgery.Conclusions: Rheolytic MT is an independent risk factor for hemoglobinuria. A proper aspiration strategy, hydration, and alkalization following thrombectomy are particularly favorable for preventing AKI.

关 键 词：Iliofemoral deep venous thrombosis Acute kidney injury HEMOGLOBINURIA THROMBECTOMY THROMBOLYSIS 

分 类 号：R692[医药卫生—泌尿科学]