F Stanek1, R Ouhrabkova, D Prochazka. 1. Department of Radiology, District Hospital Kladno, Kladno, Czech Republic. stanek.f@tiscali.cz
Abstract
BACKGROUND: The aim of the study was to evaluate the efficacy of mechanical thrombectomy using the Rotarex catheter in the treatment of peripheral arterial thromboembolic occlusions and to assess long-term results. PATIENTS AND METHODS: The Rotarex catheter is a 6F or 8F polyurethane catheter, which contains a steel spiral powered by an electric motor and rotating at a speed of 40.000 rpm. The catheter tip is connected to the spiral. The rotating spiral produces a continuous vacuum and the thromboembolic material "drilled" by the tip is drawn into the catheter, where it is fragmented and transported via the spiral to the collecting bag. RESULTS: We have conducted 43 interventions in 40 patients (20 men, 20 women), age 44-92 years (mean 76 years). The occlusion length varied from 2-37 cm (mean 8 cm); the duration of symptoms ranged from 2-180 days (mean 14 days), Thrombectomy as the only procedure was sufficient in 11 interventions (25.5%); a combination with PTA was necessary in 21 procedures (49%) and with stent implantation in 11 procedures (25.5%). Angiographic success was achieved in 41 interventions (95%). The most frequent transitory complication was embolization to the calf arteries (9%). Subsequent thrombolysis was administered after 4 procedures (9%). In one case (2%) there was a minor perforation of the peroneal artery. Six-month post-intervention follow-up is available for 34 patients. Patency was preserved in 65% and amputation had to be performed in 12%. After 12 months, 12 patients are followed and 67% of interventions have remained patent. CONCLUSIONS: The Rotarex system enables fast and efficient treatment of peripheral arterial thromboembolic occlusions. In most cases, this method is capable of replacing thrombolysis.
BACKGROUND: The aim of the study was to evaluate the efficacy of mechanical thrombectomy using the Rotarex catheter in the treatment of peripheral arterial thromboembolic occlusions and to assess long-term results. PATIENTS AND METHODS: The Rotarex catheter is a 6F or 8F polyurethane catheter, which contains a steel spiral powered by an electric motor and rotating at a speed of 40.000 rpm. The catheter tip is connected to the spiral. The rotating spiral produces a continuous vacuum and the thromboembolic material "drilled" by the tip is drawn into the catheter, where it is fragmented and transported via the spiral to the collecting bag. RESULTS: We have conducted 43 interventions in 40 patients (20 men, 20 women), age 44-92 years (mean 76 years). The occlusion length varied from 2-37 cm (mean 8 cm); the duration of symptoms ranged from 2-180 days (mean 14 days), Thrombectomy as the only procedure was sufficient in 11 interventions (25.5%); a combination with PTA was necessary in 21 procedures (49%) and with stent implantation in 11 procedures (25.5%). Angiographic success was achieved in 41 interventions (95%). The most frequent transitory complication was embolization to the calf arteries (9%). Subsequent thrombolysis was administered after 4 procedures (9%). In one case (2%) there was a minor perforation of the peroneal artery. Six-month post-intervention follow-up is available for 34 patients. Patency was preserved in 65% and amputation had to be performed in 12%. After 12 months, 12 patients are followed and 67% of interventions have remained patent. CONCLUSIONS: The Rotarex system enables fast and efficient treatment of peripheral arterial thromboembolic occlusions. In most cases, this method is capable of replacing thrombolysis.
Authors: Mariya Kronlage; Ilka Printz; Britta Vogel; Erwin Blessing; Oliver J Müller; Hugo A Katus; Christian Erbel Journal: Drug Des Devel Ther Date: 2017-04-18 Impact factor: 4.162