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
ARTICLE HIGHLIGHTS
Research background

Endovascular treatment of acute limb ischemia (ALI) is increasingly gaining importance in older and multimorbid patients, compared to conventional surgical techniques. The Rotarex®S debulking system is one such endovascular device, which can be used for catheter-assisted thrombectomy in ALI. However, the use of the 6 French (6F) Rotarex®S system is not generally recommended for crural arteries in the current literature.

Research motivation

Limited data exist to date on the efficacy and safety of the 6F Rotarex®S system for thrombectomy in crural arteries.

Research objectives

Our study aimed to examine whether the 6F Rotarex®S system can be used effectively and safely for endovascular thrombectomy of crural arteries in patients with ALI.

Research methods

Retrospective analysis of all patients who were referred to our department for endovascular thrombectomy dues to ALI between January 2015 and December 2017.

Research results

We identified seven patients who underwent endovascular Rotarex®S catheter thrombectomy in crural arteries due to remaining thrombus formation with no reflow. In two cases, thrombectomy was performed in the anterior tibial artery, in another two cases, in the posterior tibial artery and in the remaining three cases, in the fibular artery. In all seven cases, treatment resulted in restoration of the blood flow to the foot arteries, resolving ischemic symptoms. Vessel dissection or perforation did not occur in any of the seven cases..

Research conclusions

Endovascular thrombectomy using the 6F Rotarex®S catheter system may be safe and effective for the treatment of thrombotic occlusion of the proximal and mid portion of crural arteries. In particular, patients with high bleeding risk may profit from such a “mechanical only” treatment option without the need for additional thrombolysis.

Research perspectives

Larger prospective trials are necessary in the future to examine the efficacy and safety of the 6F Rotarex®S catheter system in smaller arteries of the lower limb.