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

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.