Clinical Outcomes of Percutaneous Versus Surgical Fogarty Thrombectomy in Lower Extremity Acute Limb Ischemia

Abstract

Purpose:

Percutaneous Fogarty thrombectomy is a novel and potentially less invasive alternative to surgical thrombectomy for the treatment of patients with acute limb ischemia (ALI). This study aimed to evaluate the effectiveness of percutaneous thrombectomy versus conventional surgical thrombectomy with respect to amputation-free survival (AFS) and periprocedural complications in patients with ALI.

Methods:

We conducted a multicenter, retrospective, observational study enrolling 148 patients with ALI who underwent percutaneous or surgical thrombectomy (percutaneous group, 44 patients; surgical group, 104 patients) between January 2014 and October 2023. The primary outcome measure was the 12-month AFS rate, and the secondary outcome measure was periprocedural complications. Propensity score matching analysis was applied to minimize baseline differences and to compare outcomes between the groups.

Results:

After propensity score matching, 30 and 60 patients were allocated to the percutaneous and surgical groups, respectively. The 12-month AFS was not significantly different between the groups (percutaneous group: 73.6% vs. surgical group: 53.3%, log-rank p=0.16). The incidence of major access-site bleeding, vessel perforation, wound infection, and delayed wound healing was not significantly different between the 2 groups (all p>0.05).

Conclusions:

The current study revealed that AFS rate and perioperative complications were not significantly different between patients with ALI undergoing percutaneous and surgical thrombectomy.

Clinical Impact

Percutaneous Fogarty thrombectomy is a novel and potentially less invasive alternative to surgical thrombectomy for the treatment of patients with lower extremity acute limb ischemia; however, its effectiveness and safety have not yet been fully established. This multicenter retrospective analysis found that amputation-free survival rates were not significantly different in patients undergoing the percutaneous thrombectomy, compared with those undergoing the conventional surgical thrombectomy. Future studies with a larger sample size are warranted to confirm the generalizability of the findings.