Department of Diagnostic and Interventional Radiology, University Medical Center Wuerzburg, Germany.
Diagn Interv Radiol. 2021 Mar;27(2):206-213. doi: 10.5152/dir.2021.19403.
We aimed to evaluate the role of adjunctive, solely nonthrombolytic endovascular therapy in treatment of acute lower-extremity ischemia by rotational percutaneous mechanical thrombectomy.
A retrospective, single-center evaluation of 165 patients (167 limbs) that underwent rotational percutaneous mechanical thrombectomy between 2009 and 2016 was performed.
Rotational percutaneous mechanical thrombectomy was used as a single therapy in 9.0% (15 limbs), followed by percutaneous aspiration thrombectomy in 6.0% (10 limbs), percutaneous transluminal angioplasty in 19.8% (33 limbs) and stenting in 25.7% (43 limbs). Rotational percutaneous mechanical thrombectomy was followed by any combination of these three interventions in 39.5%. Clinical and technical success was documented in 92.2%, complications in 10.3% (n=17). No significant difference in clinical and technical success was observed using rotational percutaneous mechanical thrombectomy alone or with additional endovascular therapy. On a long-term basis, the re-ischemia-free survival was nearly twice as high as in previous studies that reported more cases treated by rotational percutaneous mechanical thrombectomy alone.
To assure a long-lasting primary patency after percutaneous mechanical thrombectomy, concomitant treatment of underlying lesions with adjunctive, nonthrombolytic endovascular methods should be considered.
我们旨在评估通过旋转式经皮机械血栓切除术辅助单纯非溶栓性血管内治疗在急性下肢缺血治疗中的作用。
回顾性分析了 2009 年至 2016 年间进行的 165 例（167 条肢体）旋转式经皮机械血栓切除术患者。
9.0%（15 条肢体）患者单独采用旋转式经皮机械血栓切除术，6.0%（10 条肢体）患者采用经皮抽吸血栓切除术，19.8%（33 条肢体）患者采用经皮腔内血管成形术，25.7%（43 条肢体）患者采用支架置入术。39.5%的患者在采用旋转式经皮机械血栓切除术的基础上联合应用上述三种干预措施。92.2%的患者记录到临床和技术成功，10.3%（n=17）的患者出现并发症。单独使用旋转式经皮机械血栓切除术或联合使用其他血管内治疗，在临床和技术成功方面没有显著差异。从长期来看，再缺血无复流的生存率明显高于以前报道的单独采用旋转式经皮机械血栓切除术治疗的病例。
为确保经皮机械血栓切除术后的初始通畅率持久，应考虑采用辅助性、非溶栓性血管内方法治疗潜在病变。
