Skip to main content

Advertisement

SpringerLink
Log in

Recanalization of Acute and Subacute Femoropopliteal Artery Occlusions with the Rotarex Catheter: One Year Follow-up, Single Center Experience

  • Clinical Investigations
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose:

To assess the efficacy and safety of a new rotational catheter for percutaneous removal of fresh and organized thrombi in the femoropopliteal artery.

Methods:

Forty-one limbs in 38 patients (age 56–90 years, mean 75.6 years) with acute, subacute or chronic femoropopliteal occlusions of 1–180 days’ duration (mean 31.6 days) were treated with the Rotarex device. The Fontaine stage was mainly IIB (Rutherford 2–3, 22 patients) or III (Rutherford 4, 14 patients). The length of occlusion varied from 2 to 35 cm (mean 13.1 cm). After recanalization percutaneous transluminal angioplasty (PTA) was performed if there was a residual stenosis of >25%. Patients were followed up with color Doppler ultrasound at 48 hr and clinically with Doppler pressures and oscillometry at 3, 6, and 12 months.

Results:

After an average of two passages with the Rotarex catheter all but two limbs required PTA for residual stenosis >25%. Five patients needed additional stenting. Major complications were one groin hematoma requiring blood transfusion and one arteriovenous fistula spontaneously thrombosing after unsuccessful primary prolonged balloon dilation. Distal embolizations occurred in 10 patients; 6 clinically relevant emboli were aspirated. All occlusions were technically successfully recanalised there were 2 early reocclusions after 1 day and two at 2 weeks. Brachial–ankle indices improved from an average of 0.41 before to 0.93 after recanalization. Primary and secondary patency rates were 62% / 84% after 6 months and 39% / 68% after 1 year. The amputation-free survival at 12 months was 100%.

Conclusion:

The Rotarex mechanical thrombectomy device is an efficient, quick, easy to handle, and safe tool for the treatment of acute, subacute or even chronic peripheral arterial thromboembolic occlusions. It can be used for short or long occlusions with equal success, provided the obstruction is not heavily calcified and has been safely passed with a guidewire first.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2A–D
Figure 3A–C
Figure 4
Figure 5
Figure 6

Similar content being viewed by others

References

  1. R Morgan AM Belli (2002) ArticleTitlePercutaneous thrombectomy: A review Eur Radiol 12 205–217 Occurrence Handle10.1007/s003300101014 Occurrence Handle11868100

    Article  PubMed  Google Scholar 

  2. HJ Wagner EE Starck (1992) ArticleTitleAcute embolic occlusions of the infrainguinal arteries: Percutaneous aspiration embolectomy in 102 patients Radiology 182 403–407 Occurrence Handle1:STN:280:DyaK387itlyrtw%3D%3D Occurrence Handle10.1148/radiology.182.2.1732957 Occurrence Handle1732957

    Article  CAS  PubMed  Google Scholar 

  3. MJ Sharafuddin ME Hicks (1998) ArticleTitleCurrent status of percutaneous mechanical thrombectomy. III. Present and future applications J Vasc Interv Radiol 9 209–224 Occurrence Handle1:STN:280:DyaK1c7pvF2ksw%3D%3D Occurrence Handle10.1016/S1051-0443(98)70260-X Occurrence Handle9540903

    Article  CAS  PubMed  Google Scholar 

  4. T Zehnder M Birrer DD Do et al. (2000) ArticleTitlePercutaneous catheter thrombus aspiration for acute or subacute arterial occlusion of the legs: How much thrombolysis is needed? Eur J Vasc Endovasc Surg 20 41–46 Occurrence Handle1:STN:280:DC%2BD3cvgtF2nsQ%3D%3D Occurrence Handle10.1053/ejvs.2000.1117 Occurrence Handle10906296

    Article  CAS  PubMed  Google Scholar 

  5. MJ Sharafuddin ME Hicks (1997) ArticleTitleCurrent status of percutaneous mechanical thrombectomy. I. General principles J Vasc Interv Radiol 8 911–921 Occurrence Handle1:STN:280:DyaK1c%2FmtVersg%3D%3D Occurrence Handle10.1016/S1051-0443(97)70687-0 Occurrence Handle9399459

    Article  CAS  PubMed  Google Scholar 

  6. MJ Sharafuddin ME Hicks (1998) ArticleTitleCurrent status of percutaneous mechanical thrombectomy. II. Devices and mechanisms of action J Vasc Interv Radiol 9 15–31 Occurrence Handle1:STN:280:DyaK1c7isl2isg%3D%3D Occurrence Handle10.1016/S1051-0443(98)70477-4 Occurrence Handle9468392

    Article  CAS  PubMed  Google Scholar 

  7. N Rilinger J Gorich R Scharrer-Pamler et al. (1997) ArticleTitleShort-term results with use of the Amplatz thrombectomy device in the treatment of acute lower limb occlusions J Vasc Interv Radiol 8 343–348 Occurrence Handle1:STN:280:DyaK2s3pslCgtA%3D%3D Occurrence Handle10.1016/S1051-0443(97)70569-4 Occurrence Handle9152905

    Article  CAS  PubMed  Google Scholar 

  8. JA Reekers JG Kromhout HG Spithoven et al. (1996) ArticleTitleArterial thrombosis below the inguinal ligament: Percutaneous treatment with a thrombosuction catheter Radiology 198 49–53 Occurrence Handle1:STN:280:DyaK287itlWnsA%3D%3D Occurrence Handle10.1148/radiology.198.1.8539405 Occurrence Handle8539405

    Article  CAS  PubMed  Google Scholar 

  9. SM Tadavarthy PD Murray S Inampudi et al. (1994) ArticleTitleMechanical thrombectomy with the Amplatz device: Human experience J Vasc Interv Radiol 5 715–724 Occurrence Handle1:STN:280:DyaK2M%2FptlWlsw%3D%3D Occurrence Handle10.1016/S1051-0443(94)71590-6 Occurrence Handle8000120

    Article  CAS  PubMed  Google Scholar 

  10. WJ Drasler ML Jenson GJ Wilson et al. (1992) ArticleTitleRheolytic catheter for percutaneous removal of thrombus Radiology 182 263–267 Occurrence Handle1:STN:280:DyaK38%2FotVOitg%3D%3D Occurrence Handle10.1148/radiology.182.1.1727293 Occurrence Handle1727293

    Article  CAS  PubMed  Google Scholar 

  11. Schmitt HE, Jager KA, Jacob AL, Mohr H, Labs KH, Steinbrich W (1999) A new rotational thrombectomy catheter: System design and first clinical experiences. Cardiovasc Intervent Radiol 22:504–509

    Article  CAS  PubMed  Google Scholar 

  12. Zana K, Otal P, Fornet B, et al (2001) In vitro evaluation of a new rotational thrombectomy device: The Straub Rotarex catheter. Cardiovasc Intervent Radiol 24:319–323

    Article  CAS  PubMed  Google Scholar 

  13. Ranke C, Rieder M, Creutzig A, et al (1995) A nomogram of duplex ultrasound quantification of peripheral arterial stenoses. Studies of the cardiovascular model and in angiography patients. Med Klin (Munich) 90:72–77

    CAS  Google Scholar 

  14. D Sacks DL Marinelli LG Martin et al. (1997) ArticleTitleReporting standards for clinical evaluation of new peripheral arterial revascularization devices. Technology Assessment Committee J Vasc Interv Radiol 8 137–149 Occurrence Handle1:STN:280:DyaK2s7nslGgug%3D%3D Occurrence Handle10.1016/S1051-0443(97)70530-X Occurrence Handle9025054

    Article  CAS  PubMed  Google Scholar 

  15. EE Starck JC McDermott AB Crummy et al. (1985) ArticleTitlePercutaneous aspiration thromboembolectomy Radiology 156 61–66 Occurrence Handle1:STN:280:DyaL2M3hslegsg%3D%3D Occurrence Handle10.1148/radiology.156.1.3159042 Occurrence Handle3159042

    Article  CAS  PubMed  Google Scholar 

  16. T Zeller C Muller U Frank et al. (2001) ArticleTitle[The Straub-Rotarex thrombectomy system: initial experiences] Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 173 626–631 Occurrence Handle1:STN:280:DC%2BD3MvmvVSktA%3D%3D Occurrence Handle10.1055/s-2001-15843 Occurrence Handle11512235

    Article  CAS  PubMed  Google Scholar 

  17. H Rousseau M Sapoval P Ballini et al. (1997) ArticleTitlePercutaneous recanalization of acutely thrombosed vessels by hydrodynamic thrombectomy (Hydrolyser) Eur Radiol 7 935–941 Occurrence Handle1:STN:280:DyaK2szntlKmtw%3D%3D Occurrence Handle10.1007/s003300050230 Occurrence Handle9228112

    Article  CAS  PubMed  Google Scholar 

  18. HJ Wagner S Muller-Hulsbeck MB Pitton et al. (1997) ArticleTitleRapid thrombectomy with a hydrodynamic catheter: Results from a prospective, multicenter trial Radiology 205 675–681 Occurrence Handle1:STN:280:DyaK1c%2FlsFagug%3D%3D Occurrence Handle10.1148/radiology.205.3.9393520 Occurrence Handle9393520

    Article  CAS  PubMed  Google Scholar 

  19. M Henry M Amor I Henry et al. (1998) ArticleTitleThe Hydrolyser thrombectomy catheter: A single-center experience J Endovasc Surg 5 24–31 Occurrence Handle1:STN:280:DyaK1c7ls12gtw%3D%3D Occurrence Handle10.1583/1074-6218(1998)005<0024:THTCAS>2.0.CO;2 Occurrence Handle9497203

    Article  CAS  PubMed  Google Scholar 

  20. T Zeller U Frank K Burgelin et al. (2002) ArticleTitle[Long-term results after recanalization of acute and subacute thrombotic occlusions of the infra-aortic arteries and bypass-grafts using a rotational thrombectomy device] Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 174 1559–1565 Occurrence Handle1:STN:280:DC%2BD38jgvFOitw%3D%3D Occurrence Handle10.1055/s-2002-35942 Occurrence Handle12471529

    Article  CAS  PubMed  Google Scholar 

  21. Berczi V, Deutschmann HA, Schedlbauer P, et al (2002) Early experience and midterm follow-up results with a new, rotational thrombectomy catheter. Cardiovasc Intervent Radiol 25:275–281

    Article  PubMed  Google Scholar 

  22. K Kasirajan ZJ Haskal K Ouriel (2001) ArticleTitleThe use of mechanical thrombectomy devices in the management of acute peripheral arterial occlusive disease J Vasc Interv Radiol 12 405–411 Occurrence Handle1:STN:280:DC%2BD3M3gtVantg%3D%3D Occurrence Handle10.1016/S1051-0443(07)61877-6 Occurrence Handle11287525

    Article  CAS  PubMed  Google Scholar 

  23. K Kasirajan B Gray FP Beavers et al. (2001) ArticleTitleRheolytic thrombectomy in the management of acute and subacute limb-threatening ischemia J Vasc Interv Radiol 12 413–421 Occurrence Handle1:STN:280:DC%2BD3M3mtVyhsQ%3D%3D Occurrence Handle10.1016/S1051-0443(07)61878-8 Occurrence Handle11287526

    Article  CAS  PubMed  Google Scholar 

  24. Wagner HJ, Starck EE, Reuter P (1994) Long-term results of percutaneous aspiration embolectomy. Cardiovasc Intervent Radiol 17:241–246

    Article  CAS  PubMed  Google Scholar 

  25. K Ouriel FJ Veith AA Sasahara (1998) ArticleTitleA comparison of recombinant urokinase with vascular surgery as initial treatment for acute arterial occlusion of the legs. Thrombolysis or Peripheral Arterial Surgery (TOPAS) Investigators N Engl J Med 338 1105–1111 Occurrence Handle1:STN:280:DyaK1c7ps1KitQ%3D%3D Occurrence Handle10.1056/NEJM199804163381603 Occurrence Handle9545358

    Article  CAS  PubMed  Google Scholar 

  26. EM Jung R Lutz N Rupp (2000) ArticleTitle[Low-dose thrombolysis using rt-Pa in extensive peripheral vascular occlusion] Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 172 1028–1034 Occurrence Handle1:STN:280:DC%2BD3M7hvVWiuw%3D%3D Occurrence Handle10.1055/s-2000-9225 Occurrence Handle11199431

    Article  CAS  PubMed  Google Scholar 

  27. K Kasirajan K Ouriel (2000) ArticleTitleManagement of acute lower extremity ischemia: Treatment strategies and outcome Curr Interv Cardiol Rep 2 119–129 Occurrence Handle11096659

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, Winterthur, 8401, Switzerland

    Sylvain R. Duc, Eric Schoch & Christoph L. Zollikofer

  2. Department of Internal Medicine, Section of Angiology, Kantonsspital Winterthur, Brauerstrasse 15, Winterthur, 8401, Switzerland

    Markus Pfyffer & Regula Jenelten

Authors
  1. Sylvain R. Duc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eric Schoch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Markus Pfyffer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Regula Jenelten
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christoph L. Zollikofer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sylvain R. Duc.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duc, S.R., Schoch, E., Pfyffer, M. et al. Recanalization of Acute and Subacute Femoropopliteal Artery Occlusions with the Rotarex Catheter: One Year Follow-up, Single Center Experience. Cardiovasc Intervent Radiol 28, 603–610 (2005). https://doi.org/10.1007/s00270-004-0339-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-004-0339-3

Keywords

Search

Navigation