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Recanalization of Acute and Subacute Venous and Synthetic Bypass-Graft Occlusions With a Mechanical Rotational Catheter

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Abstract

Purpose

Percutaneous mechanical thrombectomy (PMT) is now established as an alternative treatment of acute arterial occlusions in addition to fibrinolysis and surgical thrombectomy. The objective of this retrospective study was the investigation of a rotational atherothrombectomy catheter in terms of safety and efficacy in the treatment of acute and subacute femoropopliteal bypass occlusions.

Materials and Methods

Forty-two patients (average age 65.8 ± 9.1 years) with acute (<14 days [n = 31]) and subacute (14–42 days [n = 11]) femoropopliteal bypass occlusions were treated consecutively with a rotational debulking and removal catheter (Straub Rotarex). The average occlusion length was 28.4 ± 2.9 (24–34) cm. Thirty-four (81 %) patients underwent venous bypass, and 8 (19 %) patients underwent polytetrafluoroethylene bypass.

Results

The technical success rate was 97.6 % (41 of 42). In 1 patient, blood flow could not be restored despite the use of the atherothrombectomy system. The average catheter intervention time was 6.9 ± 2.1 (4–9) min. Ankle-brachial index increased from 0.39 ± 0.13 to 0.83 ± 0.11 at discharge and to 0.82 ± 0.17 after 1 month (p < 0.05). There were a total of 2 (4.8 %) peri-interventional complications: One patient developed a distal embolism, which was successfully treated with local lysis, and another patient had a small perforation at the distal anastomosis, which was successfully treated with a stent.

Conclusion

PMT with the Rotarex atherothrombectomy catheter represents a safe and effective option in the treatment of acute and subacute femoropopliteal bypass occlusions because it can quickly restore blood flow.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westküstenklinikum Heide—Academic Teaching Hospital of the Universities of Kiel, Lübeck and Hamburg, Esmarchstrasse 50, 25746, Heide, Germany

    Christian Wissgott, Peter Kamusella & Reimer Andresen

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  1. Christian Wissgott
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  2. Peter Kamusella
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  3. Reimer Andresen
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Correspondence to Christian Wissgott.

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Wissgott, C., Kamusella, P. & Andresen, R. Recanalization of Acute and Subacute Venous and Synthetic Bypass-Graft Occlusions With a Mechanical Rotational Catheter. Cardiovasc Intervent Radiol 36, 936–942 (2013). https://doi.org/10.1007/s00270-012-0507-9

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