Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2025; 13(23): 105671
Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.105671
Retrograde approach of Angiojet catheter for the acute occlusion of aortoiliac artery stent: A case report
Sungsin Cho, Jin-Hyun Joh
Sungsin Cho, Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul 05278, South Korea
Jin-Hyun Joh, Department of Surgery, Kyung Hee University Hospital at Gangdong, Seoul 05278, South Korea
Author contributions: Cho SS contributed to this work; Joh JH designed the study; Cho SS and Joh JH conducted the study and wrote the manuscript; All authors have read and approved the final manuscript.
Informed consent statement: The study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Hyun Joh, MD, PhD, Professor, Department of Surgery, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, South Korea. jhjoh@khu.ac.kr
Received: February 7, 2025
Revised: April 9, 2025
Accepted: May 8, 2025
Published online: August 16, 2025
Processing time: 121 Days and 4.5 Hours
Abstract
BACKGROUND

Aortoiliac artery stenting has been accepted as the preferred option for the treatment of aortoiliac artery disease because of lower morbidity and mortality compared with bypass surgery. However, acute stent occlusion is a troublesome complication due to the need for open surgery or the risk of distal embolization. Herein, we reported a novel approach to treat the acute thrombotic occlusion of an aortoiliac stent using both hemolytic and conventional mechanical thrombectomy coupled with a large diameter sheath.

CASE SUMMARY

A 64-year-old male patient presented with severe claudication of the right leg. The patient's history included multiple prior interventions for aortoiliac lesions. The preoperative computed tomography (CT) imaging showed a thrombotic occlusion of right aortoiliac stenting. An Angiojet Omni thrombectomy catheter (Boston Scientific, Marlborough, MA, United States) was used to remove the thrombus in a retrograde fashion after the successful placement of the large-diameter sheath in the right common femoral artery for prevention of distal embolization. The remnant organized thrombus was removed with an over-the-wire Fogarty catheter (Edwards Lifesciences, Irvine, CA, United States). Completion angiogram and postoperative CT imaging demonstrated complete removal of thrombus and no evidence of distal embolization.

CONCLUSION

This novel approach provides successful management of acute thrombotic occlusion of aortoiliac stent without distal embolization.

Keywords: Iliac artery; Stents; Thrombosis; Endovascular procedures; Thrombectomy; Case report

Core Tip: Acute aortoiliac stent occlusion is a troublesome complication due to the need for open surgery or the risk of distal embolization. After the placement of a large-dimeter sheath in the access site, retrograde application of rheolytic thrombectomy catheter can effectively remove the thrombus. And the conventional mechanical thrombectomy can remove the remnant organized thrombus. During both rheolytic and mechanical thrombectomy, the application of a large-diameter sheath can prevent distal embolization.