Successful endovascular treatment in patients with acute thromboembolic ischemia of the lower limb including the crural arteries

• Published in: World journal of cardiology Vol. 10; no. 10; pp. 145 - 152
• Main Authors: Giusca, Sorin, Raupp, Dorothea, Dreyer, Dirk, Eisenbach, Christoph, Korosoglou, Grigorios
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 26.10.2018
• Subjects: Observational Study; Duplex sonography; Rotarex®S mechanical debulking catheter; Lower limb; Thrombus aspiration; Critical limb ischemia; Acute occlusion; Crural arteries
• ISSN: 1949-8462; 1949-8462
• DOI: 10.4330/wjc.v10.i10.145

To examine the efficacy and safety of the 6 French (6F) Rotarex S catheter system in patients with acute limb ischemia (ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels. The files of patients in our department with ALI between 2015 and 2017 were examined. In seven patients, the Rotarex S catheter was used in the proximal segment of the crural arteries. Data related to the clinical examination, Doppler sonography, angiography and follow-up from these patients were further used for analysis. Two patients (29%) had thrombotic occlusion of the common femoral artery, and the remaining five exhibited thrombosis of the superficial femoral artery and popliteal artery. Mechanical thrombectomy was performed in all cases using a 6F Rotarex S catheter. Additional Rotarex S catheter thrombectomy due to remaining thrombus formation with no reflow was performed in the anterior tibial artery in two of seven cases (29%), in the tibiofibular tract and posterior tibial artery in two of seven cases (29%) and in the tibiofibular tract and fibular artery in the remaining three of seven cases (43%). Ischemic symptoms resolved promptly in all, and none of the patients experienced a procedural complication, such as crural vessel dissection, perforation or thrombus embolization. Mechanical debulking using the 6F Rotarex S catheter system may be a safe and effective treatment option in case of thrombotic or thromboembolic occlusion of the proximal and mid-portion of crural arteries.