Mechanical thrombectomy using the rotarex catheter in the treatment of acute and subacute occlusions of peripheral arteries: Immediate results, long-term follow-up

摘要

Aim. The aim of this paper was to evaluate the immediate and long-term results of mechanical thrombectomy using the Rotarex catheter in the treatment of acute and subacute occlusions of peripheral arteries. Methods. Patients with acute or subacute occlusions of peripheral arteries were selected consecutively for treatment with the Rotarex system. The average age of our patients was 44-92 years (median [m] 75 years). The duration of symptoms ranged from 1 to 90 days (m 14 days). Results. Seventy-three interventions in 65 patients were performed. Occlusion length varied from 1 to 37 cm (m 10 cm). Immediate successful recanalization was achieved in 69 interventions (95%). Peripheral embolization represented the most frequent transitory complication (6%). Acute reocclusion following 69 successful interventions occurred in a total of 7 procedures (10%). Cumulative patency rates were 56% after 6 months, 47% after 12 months, 41% after 18 months, 37% after 24 months, 33% after 30 months and 29% after 36 months. The ankle/brachial pressure index prior to intervention ranged from 0 to 0.83 (m 0.53) and increased to 0.42-1.44 (m 0.9) post intervention (P<0.001). Its values after 6, 12, 18, 24, 30 and 36 months were statistically significantly higher than those before procedure. Major amputation was performed in 10% of cases. Conclusions. Rotarex thrombectomy represents an effective and safe modality for treating acute and subacute occlusions of peripheral arteries with excellent immediate and satisfactory long-term results. Compared to thrombolysis, the principal advantage of thrombectomy is the rapid recanalization of the given artery.