title: Recanalisation of thrombotic arterial occlusions with rotational thrombectomy.
abstract: OBJECTIVE
  This study sought to assess the effectiveness of rotational thrombectomy (RT) with the Rotarex device in the treatment of thrombotic occlusions in native arteries, by-pass grafts, stents and stent-grafts.
  
  
  METHODS
  Over the last 4 years, 22 patients (14 men and 8 women; mean age 62.6 years) affected by 5 acute (<14 days) thrombotic occlusions of the native arteries (4 plaque thromboses in the common iliac artery and one on a dissection intimal flap of the external iliac artery), 17 subacute and chronic thromboses affecting 4 femoro-popliteal by-pass grafts, 10 stents (7 in the common iliac artery and 3 in the superficial femoral artery) and 3 stents-grafts were studied. Acute thromboses of native arteries were follow-up with colour-Doppler ultrasound (US) examination at 1 and 3 months. Subacute and chronic thrombotic occlusions were follow-up with colour-Doppler US examination at 1, 3, 6 and 12 months and yearly thereafter.
  
  
  RESULTS
  Immediate technical success was achieved without any need for additional procedures in all acute occlusions of native arteries (4/22 cases). In the subacute and chronic occlusions, the procedure was completed with percutaneous transluminal angioplasty (PTA) (8/22), cutting balloon (6/22) and stenting (5/22). The complication rate was 4.8% (1 rupture of the external iliac artery repaired with a stent-graft).
  
  
  CONCLUSIONS
  Arterial recanalisation with RT is the treatment of choice for acute thrombosis of healthy native arteries (4-7 mm); the treatment of thrombosis complicating calcified plaques or dissection intimal flaps may cause rupture of the arterial wall. In subacute and chronic occlusions of by-pass grafts, stents and stent grafts, additional procedures are necessary to achieve complete recanalisation.
authors.affiliation: Department of Radiology, University of Insubria, V.le Borri 57, Varese, Italy. donlaga@gmail.com
authors.forename: D
authors.initials: D
authors.lastname: Laganà
authors.forename: G
authors.initials: G
authors.lastname: Carrafiello
authors.forename: D
authors.initials: D
authors.lastname: Lumia
authors.forename: F
authors.initials: F
authors.lastname: Fontana
authors.forename: M
authors.initials: M
authors.lastname: Mangini
authors.forename: F A
authors.initials: FA
authors.lastname: Vizzari
authors.forename: G
authors.initials: G
authors.lastname: Piffaretti
authors.forename: C
authors.initials: C
authors.lastname: Fugazzola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color