Surreal illustration of kidney with AngioJet device representing the risk of kidney injury in DVT treatment.

AngioJet Thrombectomy: Weighing the Risks of Kidney Injury in DVT Treatment

Kai Mendoza in Health & Wellness July 2025 • 4 min read.

"A new study sheds light on the potential risks of acute kidney injury (AKI) associated with the AngioJet system compared to traditional methods for treating deep vein thrombosis."

Deep vein thrombosis (DVT), particularly in the iliofemoral region, is a serious condition that can lead to long-term complications such as post-thrombotic syndrome. To minimize these risks, percutaneous mechanical thrombectomy (PMT) and catheter-directed thrombolysis (CDT) are often employed to remove the blood clot and restore proper blood flow.

Among the PMT devices, the AngioJet system has gained popularity due to its ability to rapidly break down and remove clots. However, a recent study has raised concerns about a potential side effect: an increased risk of acute kidney injury (AKI) following the procedure.

This article delves into the findings of this study, comparing the risk of AKI between AngioJet PMT and CDT, and explores the factors that may contribute to this increased risk. Understanding these nuances is crucial for patients and healthcare providers alike in making informed decisions about DVT treatment.

AngioJet vs. CDT: Understanding the Kidney Injury Risk

Surreal illustration of kidney with AngioJet device representing the risk of kidney injury in DVT treatment.

The study, published in the Journal of Vascular Surgery: Venous and Lymphatic Disorders, retrospectively examined the medical records of 198 patients with acute iliofemoral DVT. These patients underwent either AngioJet PMT or CDT between January 2014 and September 2017. The researchers then compared the incidence of postoperative AKI between the two groups.

The results indicated a significantly higher incidence of AKI in the AngioJet PMT group (22.8%) compared to the CDT group (9.2%). Further analysis revealed several independent risk factors associated with postoperative AKI, including:

Use of AngioJet PMT (odds ratio [OR], 2.82)
History of major surgery within 3 months of endovascular intervention (OR, 8.51)
Hematocrit (HCT) drop >14% (OR, 2.73)

These findings suggest that while AngioJet is effective for clot removal, it may come with a higher risk of AKI, particularly for patients who have recently undergone major surgery or experience a significant drop in hematocrit levels.

Making Informed Decisions About DVT Treatment

The study highlights the importance of carefully weighing the risks and benefits of different DVT treatment options, especially considering individual patient factors. While AngioJet PMT can be a valuable tool for rapid clot removal, healthcare providers should be aware of the increased risk of AKI, particularly in patients with recent surgical history or those prone to significant hematocrit drops. By understanding these risks and taking appropriate precautions, clinicians can optimize patient outcomes and minimize potential complications.

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Everything You Need To Know

What is AngioJet Thrombectomy, and why is it used for DVT?

AngioJet Thrombectomy is a percutaneous mechanical thrombectomy (PMT) device used to remove blood clots, specifically in the treatment of deep vein thrombosis (DVT). It's designed to rapidly break down and remove clots, restoring blood flow and minimizing the risk of complications like post-thrombotic syndrome, which is a long-term consequence of DVT, particularly when it occurs in the iliofemoral region. Its popularity stems from this ability to quickly clear blockages, providing a faster intervention compared to some other methods.

What are the primary treatment options for DVT mentioned, and how do they work?

The primary treatment options discussed are percutaneous mechanical thrombectomy (PMT) and catheter-directed thrombolysis (CDT). PMT, as exemplified by the AngioJet system, physically removes the blood clot. CDT, on the other hand, involves delivering clot-busting drugs directly to the site of the clot via a catheter, dissolving the clot over time. Both methods aim to restore blood flow and prevent long-term complications of DVT.

What are the key findings of the study regarding AngioJet and acute kidney injury (AKI)?

The study found that the AngioJet PMT group had a significantly higher incidence of acute kidney injury (AKI) compared to the CDT group. Specifically, 22.8% of patients in the AngioJet group developed AKI, while only 9.2% of those in the CDT group did. The study also identified several independent risk factors, including the use of AngioJet, recent major surgery, and a significant drop in hematocrit levels, which were associated with an increased risk of AKI.

Who is most at risk of kidney injury from the AngioJet system, and why?

Patients who have undergone major surgery within three months of the endovascular intervention and those experiencing a significant drop in hematocrit are at a higher risk of acute kidney injury when treated with the AngioJet system. The study showed a substantially increased odds ratio for AKI in those with a recent surgical history, implying a heightened susceptibility to kidney damage. The exact mechanisms are complex, but could be related to the use of contrast agents used in the procedure, and the potential for blood products and debris from the clot removal to impact kidney function.

How should healthcare providers use this information when choosing a DVT treatment?

Healthcare providers should carefully weigh the risks and benefits of different DVT treatment options, especially considering individual patient factors. While AngioJet PMT can be effective for rapid clot removal, the increased risk of AKI, especially in patients with recent surgical history or significant hematocrit drops, should be considered. Clinicians must understand these risks and take appropriate precautions, potentially including more vigilant monitoring of kidney function, to optimize patient outcomes and minimize complications. This also could mean choosing alternative methods like CDT for those at higher risk.