[Rotation aspiration thromboembolectomy].

Rotating aspiration thromboembolectomy (RAT) was performed in 32 patients (11 women and 21 men; mean age 68 [41-92] years with infrainguinal arterial occlusion, various conventional angioplasty techniques having been unsuccessful. Mean length of occlusion was 19.7 cm (2-47 cm). 17 patients were in stage IIb, 8 in stage III and 7 in stage IV (Fontaine classification). RAT consists of mechanical fragmentation of thrombotic or embolic occlusion material during simultaneous infusion of urokinase, followed by aspiration of the material. Primary success (residual stenosis less than or equal to 50%) was demonstrated by angiography in 31 of 32 patients, while primary clinical success (reduction by at least one Fontaine stage) occurred in 29 patients. These results demonstrate that RAT is a suitable method for the percutaneous intraluminal treatment of long thrombotic or embolic occlusions in which conventional angioplasty techniques have previously failed.