Mechanical thrombectomy in proximal subclavian artery in-stent occlusion.
OBJECTIVE
Mechanical thrombectomy is an established tool for endovascular therapy of acute/chronic in-stent occlusions of the lower extremities, especially for the superficial femoral artery. The authors report the use of the Rotarex catheter system for an in-stent proximal subclavian occlusion.


METHODS
A 51-year-old female patient with previous multiple attempts at left subclavian revascularization; primary endovascular stenting at the origin of the subclavian artery occluded at 3 months, and a carotid-subclavian bypass was placed distally to the stent. After 6 months from the first treatment, the patient was readmitted with an acute left arm ischemia and full occlusion of the bypass was confirmed at computed tomography angiography. An anterograde thrombectomy for in-stent restenosis, together with PTA with a drug-eluting balloon was performed in the subclavian artery with confirmed patency at 6 months.


CONCLUSIONS
Mechanical thrombectomy together with drug-eluting balloon PTA for in-stent occlusion or restenosis of the subclavian artery could be a promising procedure with a lower invasivity and risk with respect to surgical options.
Department of Vascular Surgery, University of Modena and Reggio Emilia, Nuovo Ospedale S. Agostino Estense, Modena, Via Giardini, 1355, 41100, Baggiovara (MO), Italy.
Roberto
R
Silingardi
Antonio
A
Lauricella
Valentina
V
Cataldi
Mistral Klend Sacha
MK
Njila
Gioacchino
G
Coppi
D000800:Angioplasty, Balloon; D057785:Catheters; D005260:Female; D006801:Humans; D061185:Mechanical Thrombolysis / Q000295:instrumentation* / Q000379:methods; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome