Lichtenberg Michael, Stahlhoff Wilhelm, Boese Dirk, Hailer Birgit
Cardiovascular Clinic, Vascular Center, Katholisches Klinikum Essen, Essen, Germany.
Cardiovasc Interv Ther. 2013 Apr;28(2):178-83. doi: 10.1007/s12928-012-0152-x. Epub 2012 Dec 15.
Acute and subacute ischemia of the legs in acute and subacute femoropopliteal bypass occlusion is a dramatic situation that endangers the survival of the limbs, depending on the severity of the ischemia. Different therapy options like percutaneous mechanical thrombectomy procedures, which include rotational thrombectomy, have become available in recent years in addition to local lysis and surgical thrombectomy. Rotational thrombectomy with the Straub Rotarex(®) System as an endovascular therapy option has demonstrated promising results leading to amputation-free survival in multiple studies. We recently provided data of 22 patients with acute femoropopliteal bypass occlusion where we examined the feasibility of the Rotarex(®) System in this indication. A technical success rate of 82% was demonstrated. During a follow-up period of 6 months, no reinterventions in these patients had to be performed. We now provide patency rates in 21 patients of our study group after a follow-up period of 12 months. The average ABI after 12 months was 0.80 ± 0.1. One patient showed a hemodynamic restenosis in a Nitinolstent distal to the femoropopliteal bypass which was implanted in the index procedure. No reocclusion of the femoropopliteal bypasses occurred in all patients.
急性和亚急性股腘动脉搭桥闭塞时下肢的急性和亚急性缺血是一种危急情况，会危及肢体存活，这取决于缺血的严重程度。近年来，除了局部溶栓和手术取栓外，不同的治疗选择如经皮机械血栓清除术（包括旋转血栓清除术）已可供使用。使用Straub Rotarex®系统进行旋转血栓清除术作为一种血管内治疗选择，在多项研究中已显示出有希望的结果，可实现无截肢存活。我们最近提供了22例急性股腘动脉搭桥闭塞患者的数据，在该研究中我们检验了Rotarex®系统在该适应症中的可行性。结果显示技术成功率为82%。在6个月的随访期内，这些患者无需再次干预。我们现在提供我们研究组21例患者在12个月随访期后的通畅率。12个月后的平均踝肱指数为0.80±0.1。1例患者在初次手术中植入的股腘动脉搭桥远端的镍钛合金支架出现血流动力学再狭窄。所有患者的股腘动脉搭桥均未再次闭塞。
