title: Recanalization of acute and subacute venous and synthetic bypass-graft occlusions with a mechanical rotational catheter.
abstract: OBJECTIVE
  Percutaneous mechanical thrombectomy (PMT) is now established as an alternative treatment of acute arterial occlusions in addition to fibrinolysis and surgical thrombectomy. The objective of this retrospective study was the investigation of a rotational atherothrombectomy catheter in terms of safety and efficacy in the treatment of acute and subacute femoropopliteal bypass occlusions.
  
  
  METHODS
  Forty-two patients (average age 65.8 ± 9.1 years) with acute (<14 days [n = 31]) and subacute (14-42 days [n = 11]) femoropopliteal bypass occlusions were treated consecutively with a rotational debulking and removal catheter (Straub Rotarex). The average occlusion length was 28.4 ± 2.9 (24-34) cm. Thirty-four (81%) patients underwent venous bypass, and 8 (19%) patients underwent polytetrafluoroethylene bypass.
  
  
  RESULTS
  The technical success rate was 97.6% (41 of 42). In 1 patient, blood flow could not be restored despite the use of the atherothrombectomy system. The average catheter intervention time was 6.9 ± 2.1 (4-9) min. Ankle-brachial index increased from 0.39 ± 0.13 to 0.83 ± 0.11 at discharge and to 0.82 ± 0.17 after 1 month (p < 0.05). There were a total of 2 (4.8%) peri-interventional complications: One patient developed a distal embolism, which was successfully treated with local lysis, and another patient had a small perforation at the distal anastomosis, which was successfully treated with a stent.
  
  
  CONCLUSIONS
  PMT with the Rotarex atherothrombectomy catheter represents a safe and effective option in the treatment of acute and subacute femoropopliteal bypass occlusions because it can quickly restore blood flow.
authors.affiliation: Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westküstenklinikum Heide-Academic Teaching Hospital of the Universities of Kiel, Lübeck and Hamburg, Esmarchstrasse 50, 25746, Heide, Germany. cwissgott@wkk-hei.de
authors.forename: Christian
authors.initials: C
authors.lastname: Wissgott
authors.forename: Peter
authors.initials: P
authors.lastname: Kamusella
authors.forename: Reimer
authors.initials: R
authors.lastname: Andresen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D055109:Ankle Brachial Index; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000379:methods; D057785:Catheters; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D011150:Popliteal Artery / Q000601:surgery; D015641:Radiography, Interventional / Q000379:methods; D012039:Regional Blood Flow / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017131:Thrombectomy / Q000295:instrumentation* / Q000379:methods; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods