Acute thrombotic subclavian artery occlusion treated with a new rotational thrombectomy device.

Abstract

To report the use of a new rotational thrombectomy device for percutaneous thrombectomy of an acutely occluded subclavian artery. A 71-year-old woman with a history of multivessel coronary disease complained of sudden onset of pain at rest and paleness of the left arm. Duplex ultrasound showed a localized thrombotic occlusion of the postvertebral subclavian artery and another at the bifurcation of the brachial artery. After angiographic confirmation, the subclavian artery was recanalized with an 8-F Rotarex device via a percutaneous transfemoral access; the bifurcation of the brachial artery was recanalized by local thrombolysis (50 mg rtPA) because the thrombectomy device was too short to reach the occlusion. Follow-up examinations up to 1 year have shown normalized perfusion of the left arm. This new thrombectomy device is a useful tool for the percutaneous treatment of acute occlusion in the brachiocephalic arteries.