Successful endovascular treatment in patients with acute thromboembolic ischemia of the lower limb including the crural arteries.

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.