Percutaneous pharmacomechanical thrombectomy using AngioJet® for acute limb ischaemia due to infective endocarditis: a case report

Abstract Background Acute limb ischaemia (ALI) is a potential thromboembolic complication of infective endocarditis (IE), which requires immediate attention to prevent permanent ischaemic injury and loss of limb. Given the complex haemostatic dysregulation inherent to IE, balancing the thrombotic and haemorrhagic risk is critical in its management. Case summary This study follows a patient diagnosed with ALI Rutherford IIa due to infective endocarditis from Streptococcus sanguinis infection. The patient was successfully treated with percutaneous mechanical thrombectomy using AngioJet®. Angio graphic evaluation showed restored distal arterial flow with no residual thrombus. At follow-up, the patient had returned to their daily activities without complaints. Discussion ALI secondary to IE is traditionally treated with surgical embolectomy. However, endovascular techniques have emerged as an increasingly preferred first-line therapy, offering comparable clinical efficacy to open surgery alongside enhanced postoperative recovery. To our knowledge, this case represents the first reported use of AngioJet® percutaneous pharmacomechanical thrombectomy for ALI caused by infective endocarditis. Despite the success observed in this particular patient, this approach should remain limited to carefully selected cases until further evidence on its safety and efficacy is available.