AngioJet Thrombectomy

Thrombectomy involves removal of thrombus from the vasculature. Thrombotic lesions are common in STEMI (acute myocardial infarction), peripheral thromboembolic events and venous thrombosis. Thrombectomy can be passive (suction devices such as Export, Pronto, ..) or active (Angioject, Ultrasonic, EKOS) and can be combined with lytic therapy (pulse lysis).


The Possis AngioJet catheter is a 140 cm long, 5 F, stainless steel catheter, which tapers to 3.5 F at the distal 5 cm. The catheter is attached to a driving unit which roller pump generates high-speed pulsed flow (50 ml/min) pushed into a high-pressure lumen. This lumen ends up in a 180° loop that separates into 6 high-pressure jets, directed retrograde into the collecting lumen of the catheter. The saline, which exits the loop at a speed of about 450 km/h, creates a vortex that fragments the thrombus and the venturi effects creates a vacuum that aspirates the thrombus material.The AngioJet catheter is advanced through the suspected thrombus and positioned distally. The unit and aspiration is then activated and the catheter is pulled back slowly at the rate of 0.5 mm/s. Multiple passes are performed until no further improvement is noted. Angiojet thrombectomy is used for thrombotic vessels including coronary thrombosis in acute myocardial infarction, stent thrombosis, saphenous vein graft thrombus, thrombosed dialysis fistula, thrombosed peripheral vessels, and occasionally in acute pulmonary embolism for pulmonary artery thromboembolism. Thrombectomy may be combined with distal protection devices to limit distal embolization.