Acute arterial and venous thrombotic events, such as acute limb ischemia (ALI) and venous thromboembolism (VTE), present urgent clinical scenarios requiring prompt intervention. The AngioJet® system is a pharmacomechanical thrombectomy device used for acute arterial and venous thrombus removal. It delivers a plasminogen-activating agent directly into the thrombus, reducing mechanical vessel trauma and enabling effective thrombolytic drug distribution. The device has shown high success rates, with 90% of patients completing mechanical thrombectomy successfully and an average hospital stay of 4.2 ± 1.4 days. Despite its efficacy, the AngioJet® system carries a risk of acute kidney injury (AKI). AKI incidence rates following AngioJet thrombolysis vary from 11.4% to 29%, with risk factors including prolonged thrombectomy duration, increased contrast volume, concurrent pulmonary thrombectomy, diabetes, PE, hypertension, and recent major surgery. Most AKI cases resolve within three months post-operatively. Our study involved 304 AngioJet thrombolysis cases in 230 patients, with a mean age of 65.79 years. The peri-operative protocol included pre-operative IV hydration, intra-operative anticoagulation, and post-operative monitoring and hydration. Thrombectomy time was limited to less than 240 seconds, and the lytic dose of tissue plasminogen activator was capped at 20 mg. Out of 304 cases, 6 patients developed AKI on day 1, 7 on day 3, and 5 on day 5. A significant relationship was found between AKI and diabetes (p = 0.035, Cramer V 0.126), and thrombectomy time (p = 0.031). The ROC model indicated an AKI risk inflection point at 155 seconds of thrombectomy time. Complications included 11 technical failures (3.6%), 12 major amputations (3.9%), and 2 deaths (0.7%). Our study demonstrates the use of a peri-operative protocol which reduces incidence of AKI to comparators.