Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Oct 26, 2018; 10(10): 145-152
Published online Oct 26, 2018. doi: 10.4330/wjc.v10.i10.145
Successful endovascular treatment in patients with acute thromboembolic ischemia of the lower limb including the crural arteries
Sorin Giusca, Dorothea Raupp, Dirk Dreyer, Christoph Eisenbach, Grigorios Korosoglou
Sorin Giusca, Grigorios Korosoglou, Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Weinheim 69469, Germany
Dorothea Raupp, Christoph Eisenbach, Department of Gastroenterology and Diabetology, GRN Hospital Weinheim, Weinheim 69469, Germany
Dirk Dreyer, Straub Medical AG, Wangs CH-7323, Switzerland
Author contributions: Giusca S, Dreyer D and Korosoglou G designed the research; Giusca S, Raupp D, Eisenbach C and Korosoglou G performed the research; Giusca S, Dreyer D and Korosoglou G contributed analytic tools; Giusca S, Raupp D, Eisenbach C and Korosoglou G analyzed data; Giusca S, Raupp D, Dreyer D, Eisenbach C and Korosoglou G wrote the paper.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at University Hospital Heidelberg, Heidelberg, Germany.
Informed consent statement: The patients involved in this study gave their written informed consent authorizing use and disclosure of their protected health information.
Conflict-of-interest statement: Dirk Dreyer is an employee of the Straub Medical AG. All other authors have no conflicts of interests to declare.
Data sharing statement: No additional data are available.
STROBE statement: This report is presented as suggested by the STROBE statement, i.e., according to the guidelines for reporting observational studies.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Grigorios Korosoglou, MD, Professor, Department of Cardiology and Vascular Medicine, GRN Hospital Weinheim, Roentgenstrasse 1, Weinheim 69469, Germany. gkorosoglou@hotmail.com
Telephone: +49-6201-892142 Fax: +49-6201-892507
Received: May 13, 2018
Peer-review started: May 13, 2018
First decision: June 14, 2018
Revised: June 30, 2018
Accepted: August 11, 2018
Article in press: August 11, 2018
Published online: October 26, 2018
Abstract
AIM

To examine the efficacy and safety of the 6 French (6F) Rotarex®S catheter system in patients with acute limb ischemia (ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels.

METHODS

The files of patients in our department with ALI between 2015 and 2017 were examined. In seven patients, the Rotarex®S catheter was used in the proximal segment of the crural arteries. Data related to the clinical examination, Doppler sonography, angiography and follow-up from these patients were further used for analysis.

RESULTS

Two patients (29%) had thrombotic occlusion of the common femoral artery, and the remaining five exhibited thrombosis of the superficial femoral artery and popliteal artery. Mechanical thrombectomy was performed in all cases using a 6F Rotarex®S catheter. Additional Rotarex®S catheter thrombectomy due to remaining thrombus formation with no reflow was performed in the anterior tibial artery in two of seven cases (29%), in the tibiofibular tract and posterior tibial artery in two of seven cases (29%) and in the tibiofibular tract and fibular artery in the remaining three of seven cases (43%). Ischemic symptoms resolved promptly in all, and none of the patients experienced a procedural complication, such as crural vessel dissection, perforation or thrombus embolization.

CONCLUSION

Mechanical debulking using the 6F Rotarex®S catheter system may be a safe and effective treatment option in case of thrombotic or thromboembolic occlusion of the proximal and mid-portion of crural arteries.

Keywords: Thrombus aspiration, Rotarex®S mechanical debulking catheter, Crural arteries, Lower limb, Critical limb ischemia, Acute occlusion, Duplex sonography

Core tip: Herein, we report on seven consecutive patients with acute limb ischemia, who were treated by an endovascular approach, using the 6 French (6F) Rotarex®S catheter system for local mechanical thrombectomy. The procedures were effective in all cases, restoring flow and abolishing ischemic symptoms without causing any complications. Thus, mechanical debulking using the 6F Rotarex®S catheter system may be a safe and effective treatment option in the case of thrombotic occlusion of the proximal and mid-portion of crural arteries, obviating the need for local thrombolysis, which is associated with an increased risk for major bleeding.