Tamashiro Alberto, Villegas Miguel, Tamashiro Gustavo, Enterrios Daniel, Dini Andrés, Balestrini Aristóbulo, Diaz José A
Hospital Nacional Alejandro Posadas, Illia s/n y Marconi, El Palomar (1706), Pcia de Buenos Aires, Argentina.
Cardiovasc Intervent Radiol. 2006 Sep-Oct;29(5):854-6. doi: 10.1007/s00270-005-0306-7.
Conventional vascular surgery and balloon angioplasty have poor results in severe and diffuse atherosclerotic disease of the infrapopliteal arteries. High-speed rotational atherectomy (Auth Rotablator) has not succeeded either, because of poor long-term patency and the non-reflow phenomenon. We report a case of limb salvage with long occlusion of the three infrapopliteal vessels. The anterior tibial artery was treated with retrograde Auth Rotablator atherectomy by an open approach through the pedal artery, resulting in full patency of the anterior tibial artery and healing of the skin lesions. The microparticulate debris from the ablation was drained out through the pedal arteriotomy, avoiding the complications associated with conventional antegrade high-speed rotational atherectomy.
传统的血管手术和球囊血管成形术对于腘动脉以下严重弥漫性动脉粥样硬化疾病的治疗效果不佳。高速旋切术（Auth Rotablator）也未取得成功，原因在于长期通畅率低以及无复流现象。我们报告一例伴有三条腘动脉以下血管长期闭塞的肢体挽救病例。通过经足动脉开放入路对胫前动脉进行逆行Auth Rotablator旋切术，使胫前动脉完全通畅，皮肤病变愈合。消融产生的微粒碎片通过足动脉切开处排出，避免了与传统顺行高速旋切术相关的并发症。
