Acute Pancreatitis after Percutaneous Mechanical Thrombectomy: Case Report and Review of the Literature

Acute Pancreatitis Following Pharmacomechanical Thrombectomy: A Rare Complication

A 35-year-old female presented to the emergency department (ED) with a three-day history of left lower limb edema and discomfort. A venous duplex scan and computed tomography (CT) venogram showed a left iliofemoral deep vein thrombosis (DVT). The CT also demonstrated compression of the left common iliac vein by the right common iliac artery, suggesting May-Thurner syndrome.   The iliofemoral DVT was treated with pharmacomechanical thrombectomy (PMT), which resulted in successful revascularization of the left common iliac and femoral veins.  The following day the patient developed severe epigastric pain with raised amylase levels, leading to a diagnosis of acute interstitial pancreatitis, which was thought to be secondary to massive hemolysis.   Despite the general tolerability of mechanical thrombectomy, complications such as hemorrhage, pseudoaneurysm, and dissection may occur.  Acute pancreatitis post-thrombectomy is rare, with very few cases reported in the literature, primarily documented in patients with renal insufficiency and co-morbidities. Awareness of acute pancreatitis as a rare complication post-procedure is crucial, especially when abdominal pain is unexplained.

Acute hepatitis post arteriovenous graft thrombectomy of hemodialysis vascular access

The following paper reports the case of a woman on in-center hemodialysis through an arteriovenous graft, who attended with an acute vascular access thrombosis. Post percutaneous thrombectomy, the patient presented a rare case of self-limited acute hepatitis secondary to the revascularization procedure. We explain the probable trigger for this complication, its pathophysiology, management, and evolution.

Acute Pancreatitis: A Rare Complication After Percutaneous Mechanical Thrombectomy of Portal Vein Thrombosis

BACKGROUND

Acute pancreatitis caused by Percutaneous Mechanical Thrombectomy treatment is extremely rare, and so far, no clinical report involving portal veins has been reported. In the article, we summarize this unusual case and share our experience.

METHODS

Percutaneous mechanical thrombectomy was performed for the patient who was diagnosed with portal vein thrombosis. Postoperatively, the patient was complicated by acute pancreatitis and received a series of medical treatments.

RESULTS

During the first month of follow-up, the patient was free of any clinical symptoms or signs.

CONCLUSIONS

When performing percutaneous mechanical thrombectomy therapy, it is crucial to grasp the time limit strictly, strengthen perioperative rehydration and urine alkalinization to prevent massive hemolysis and subsequent complications. Early detection and the early administration of therapy for this potentially severe complication are essential for obtaining a good prognosis.

Acute Distress Respiratory Syndrome and Cardiac Shock after AngioJet Thrombectomy for Acute Occlusion of an Aortic Endograft

Partial thrombosis or total occlusion of aortic or limb graft are possible complications after endovascular aneurysm repair. Different strategies for therapeutic management are available; these include open surgical techniques or endovascular treatments. The choice of the treatment depends on the patient's clinical conditions and on the timing of the thrombosis. Bypass still remains the first choice in case of chronic occlusion but in the last 10 years, the use of percutaneous mechanical/rheolytic thrombectomy systems is increasing. These devices can be used in case of acute or subacute onset of native arterial and venous thrombosis or embolism and in case of graft occlusion. AngioJet is a percutaneous rheolytic mechanical thrombectomy system. Through a pressurized saline solution jet, a low-pressure zone is made up and the thrombus is fragmented and aspirated by the device. Different transient adverse effects caused by lysis of the thrombus are described such as hemoglobinuria but in some cases the release of high doses of the thrombus degradation products such as heme and adenosine diphosphate can lead to fatal consequences for the patient. We reported a case of an acute onset of acute distress respiratory syndrome, pulmonary edema, cardiac shock, and renal failure following AngioJet thrombectomy in an 81-year-old man with an acute occlusion of an aortic endograft.

A rare cause of acute pancreatitis: Percutaneous mechanical rheolytic thrombectomy of deep venous thrombosis

Introduction

Percutaneous mechanical rheolytic thrombectomy is an effective treatment option for deep vein thrombosis as well as arterial and graft thromboses. Acute pancreatitis, a rare complication of this technique, is described in this case report.

Case report

A 40-year-old man underwent AngioJet mechanical rheolytic thrombectomy for iliocaval deep vein thrombosis. He subsequently developed acute pancreatitis. This case report outlines the clinical presentation of acute pancreatitis after rheolytic thrombectomy and also discusses the possible pathogenesis and etiological factors.