The use of rotational thrombectomy in the treatment of arterial thrombosis
Rotation thrombectomy is a modern method of treating peripheral arterial disease. To date, there are no randomized studies regarding rotational thrombectomy. We want to share our own results in the treatment of patients with arterial thrombosis in the treatment of 8 patients with arteriosclerosis of the lower extremities, complicated by thrombosis using Rotarex. Patients noted the acute onset of the disease, but were referred to the clinic after 2 weeks since the onset of clinical signs of the disease. All patients underwent ultrasound examination, arteriography of the affected arterial segment. After treatment, all patients underwent control angiography. During the procedure, heparin and clopidogrel were administered. One patient had systemic lupus erythematosus. Patients had thrombosis of the femoro-popliteal arterial segments. All patients had a critical ischemia of the lower extremities. Men were 6, women — 2. 2 (25%) of patients had thrombosis of the stent of the superficial femoral artery. In 8 (100%) cases, rotational thrombectomy with rotary catheter was used. For the procedure, catheters with a diameter of 6F and a length of 110–135 cm were used. During the procedure, a catheter was performed from 3 to 5 passages in the affected segment. Duration of the procedure was 1.5–2 hours. In 6 (75%) cases, after the thrombectomy, ballooning of the affected segment was used with a balloon covered with polytaxel. In 8 (100%) patients, there was a clinical improvement. In 8 (100%) patients, control arteriography showed complete patency of the affected segments of the femoral and popliteal arteries. In 8 patients, ischemia was regressed. Cases of rethrombosis were not observed. Thus, rotation thrombectomy is a modern and effective method of treatment of arterial thrombosis of the femoral and popliteal segment.
2. Bérczi, V., Deutschmann, H. A., Schedlbauer, P., Tauss, J. & Hausegger, K. A. (2002). Early experience and midterm follow-up results with a new, rotational thrombectomy catheter. Cardiovasc. Intervent. Radiol., 25 (4), 275–281. DOI: 10.1007/s00270-001-0095-6.
3. Heller, S., Lubanda, J, Varejka, P., Chochola, M., Prochazka, P., Rucka, D. … Linhart A. (2017). Percutaneous Mechanical Thrombectomy Using Rotarex® S Device in Acute Limb Ischemia in Infrainguinal Occlusions. Biomed. Res. Int., 2362769. doi: 10.1155/2017/2362769.
4. Kronlage, M., Printz, I., Vogel, B., Blessing, E., Müller, O. J., Katus, H. A. & Erbel, C. (2017). A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis. Drug Des. Devel. Ther., 11, 1233–1241. doi: 10.2147/DDDT.S131503.
5. Neumayer, C., Panhofer, P., Nanobashvili, J. & Polterauer, P. (2005). Therapeutic options on femoral artery occlusion: indications, techniques and results – a vascular surgeon's view. Zeitschrift fur Gefassmedizin, 2 (3), 4–11.
6. Ouriel, K., Shortell, C. K., DeWeese, J. A., Green, R. M., Francis, C. W., Azodo, M. V. … Marder, V. J. (1994). A comparison of thrombolytic therapy with operative revascularization in the initial treatment of acute peripheral arterial ischemia. Journal of Vascular Surgery, 19 (6), 1021–1030. doi: 10.1016/S0741-5214(94)70214-4.
7. Ouriel, K., Veith, F. J. & Sasahara, A. A. (1998). A comparison of recombinant urokinase with vascular surgery as initial treatment for acute arterial occlusion of the legs. New England Journal of Medicine, 338 (16), 1105–1111. DOI:10.1056/NEJM199804163381603.
8. Stanek, F., Ouhrabkova, R. & Prochazka, D. (2010). Mechanical thrombectomy using the Rotarex catheter–safe and effective method in the treatment of peripheral arterial thromboembolic occlusions. Vasa, 39 (4), 334–340. doi: 10.1024/0301-1526/a000058.
9. Stanek, F., Ouhrabkova, R. & Prochazka, D. (2018). Could mechanical thrombectomy replace thrombolysis in the treatment of acute and subacute limb ischemia? Minerva Cardioangiol., Aug 28. doi: 10.23736/S0026-4725.18.04770-9.
10. The STILE Investigators. (1994). Results of a prospective randomized trial evaluating surgery versus thrombolysis for ischemia of the lower extremity: the STILE trial. Annals of Surgery, 220 (3), 251–268. https://www.ncbi.nlm.nih.gov/pubmed/8092895.
11. Wissgott, C., Kamusella, P., Richter, A., Klein-Weigel, P. & Steinkamp, H. J. (2008). Mechanical rotational thrombectomy for treatment thrombolysis in acute and subacute occlusion of femoropopliteal arteries: retrospective analysis of the results from 1999 to 2005. RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, 180 (4), 325–331. doi: 10.1055/s-2008-1027144.
12. Wissgott, C., Kamusella, P., Richter, A., Klein-Weigel, P., Schink, T. & Steinkamp, H. J. (2008). Treatment of acute femoropopliteal bypass graft occlusion: comparison of mechanical rotational thrombectomy with ultrasound-enhanced lysis. Rofo, 180 (6), 547–552. doi: 10.1055/s-2008-1027216.
13. Zeller T., Frank U., Bürgelin K., Schwarzwälder, U., Horn, B., Flügel, P. C. & Neumann, F. J. (2002). Long-term results after recanalization of acute and subacute thrombotic occlusions of the infra-aortic arteries and bypass-grafts using a rotational thrombectomy device. RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, 174 (12), 1559–1565. DOI: 10.1055/s-2002-35942.
14. Zeller, T., Frank, U., Bürgelin, K., Müller, C., Flügel, P., Horn, B. … Neumann, F. J. (2003). Early experience with a rotational thrombectomy device for treatment of acute and subacute infra-aortic arterial occlusions. Journal of Endovascular Therapy, 10 (2), 322–331. DOI: 10.1177/152660280301000224.
This work is licensed under a Creative Commons Attribution 4.0 International License.