Mechanical thrombectomy using the Rotarex catheter--safe and effective method in the treatment of peripheral arterial thromboembolic occlusions.

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.