E2689. Mechanical Thrombectomy Using Rotarex Device in Peripheral Arterial Thrombosis
  1. Hyoung Ook Kim; Chonnam National University Hospital
  2. Byung Chan Lee; Chonnam National University Hospital
  3. Byung Hyun Baek; Chonnam National University Hospital
To present the immediate and midterm results of rotational mechanical thrombectomy using Rotarex catheter in acute or subacute limb ischemia which shows the “target" sign in CT angiography (CTA).

Materials and Methods:
Between March 2017 and October 2021, patients who showed the thrombotic occlusion in CTA were treated with rotational thrombectomy device (Rotarex, Straub Medical AG). Hemodynamic success (increase in the ankle-brachial index) was analyzed using Wilcoxon signed rank test. Freedom from death, amputation, and major adverse limb events (MALEs) were evaluated using Kaplan-Meier method.

A total of 46 sessions in 43 patients were treated using Rotarex devices. All patients show the “target" sign in CTA. The mean age of patients was 70.3 years old. Presenting symptoms were classified according to Fontaine stage as follows: Stage IIa (n = 8), IIb (n = 14), III (n = 19), and IV (n = 8). Mean lesion length was 27.1 cm. Involving sites were superficial femoral artery (SFA) (n = 16), popliteal artery (PA) (n = 6), SFA-PA (n = 16), common femoral artery (CFA)-SFA (n = 1), PA-tibioperoneal trunk (TPT) (n =1), SFA-TPT (n = 1), iliac artery-SFA (n = 2), and CFA-PA (n = 1). Etiologies of lesion were de native occlusion (n = 24), stent occlusion (n = 12), in-stent restenosis (n = 5), embolism (n = 1), post-surgical thrombectomy (n = 1) and bypass graft occlusion (n = 1). Technical success rate was 100%. Kinds of procedure were as follows; Rotarex only (n = 6), Rotarex + drug coated balloon (DCB) (n = 18), Rotarex + stent (n = 8), Rotarex + percutaneous transluminal angioplasty (n = 9), Rotarex + urokinase (n = 1), and Rotarex + DCB + stent (n = 1). Procedure-related complications were distal embolism (n = 1), dissection (n = 1) and puncture sites pseudoaneurysm (n = 2). Recurrence in 10 cases (among them re-do with Rotarex in 3 cases). Hemodynamic success was 86%. Thirty-day amputation-free survival was 100%. Mortality-free survival, amputation-free survival, and MALE-free survival during 12-month follow-up were 93%, 97.1% and 67.4%, respectively.

Percutaneous mechanical thrombectomy in arterial thrombosis using Rotarex catheter showed the safe result with acceptable technical success rate.