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• W3204536754 abstract "Percutaneous pharmacomechanical thrombectomy is a preferred treatment for certain patients with acute thrombosis. Various devices have been approved for this purpose, including a rheolytic thrombectomy device (rPMT). Reported studies have noted an association between the use of an rPMT and acute kidney injury (AKI) and acute renal failure. Our objective was to determine whether an aggressive perioperative hydration strategy would minimize the potential for deleterious renal outcomes, especially in the setting of acute iliofemoral deep vein thrombosis (IF-DVT). We performed a retrospective review of prospectively collected data of patients with IF-DVT who had undergone rPMT within our urban hospital system. The patients had undergone either a renal protective hydration protocol (RPHP) or normal perioperative fluid resuscitation. The baseline demographics, comorbidities, procedural details, and relevant laboratory test values were recorded. The RPHP consisted of a 1-L normal saline bolus, if the ejection fraction was >40%, given 1 hour before surgery with a repeated 1-L bolus during the tissue plasminogen activator dwell time. Postoperatively, the patients had received 200 mL/h of normal saline for 12 hours if their weight was <70 kg and 250 mL/h of normal saline for 12 hours if their weight was >70 kg. AKI was defined as an absolute increase in serum creatinine >0.3 mg/dL or an increase of 1.5 times from the baseline serum creatinine level within 48 hours of the procedure. The preoperative thrombotic burden was calculated using the Marder score. Statistical analyses were performed. After application of the exclusion criteria, 79 patients were included in the review. Of the 79 patients, 55 (69.6%) had received the RPHP. Of the 79 patients, 20 (25.3%) had had bilateral IF-DVT. Overall, 21 patients (26.5%) had developed AKI, 16 of whom had received the RPHP (P = .5827). The use of bilateral procedures had a statistically significant association with the development of AKI (P = .0002). However, no significant difference was seen within this subset when controlling for the hydration protocol used (P = .3246). These patients had had significantly higher Marder scores (P = .0228). No significant association was seen between the preoperative Marder score and the occurrence of AKI in either patient group (RPHP, P = .0706; no RPHP, P = .8691). No statistically significant reduction was found in the incidence of AKI after rPMT with aggressive fluid hydration. Bilateral IF-DVT was associated with higher Marder scores and an increased incidence of AKI, which might imply that the clot burden, rather than run time, might increase an individual's risk of postoperative renal complications." @default.
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• W3204536754 date "2021-10-01" @default.
• W3204536754 modified "2023-09-27" @default.
• W3204536754 title "Effect of Perioperative Hydration After Rheolytic Thrombectomy for Iliofemoral Deep Vein Thrombosis" @default.
• W3204536754 doi "https://doi.org/10.1016/j.jvs.2021.07.051" @default.
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