Mechanical Thrombectomy Using Kissing Y-Solitaire as a Rescue Treatment for Refractory Acute Popliteal and Infrapopliteal Occlusion in Elderly Patients

Abstract

Six patients were included to retrospectively review the preliminary efficacy and safety of mechanical thrombectomy using kissing Y-Solitaire as a rescue treatment. This technique was performed following failed single Solitaire thrombectomy in 5 patients (5/6), and the remaining patient (1/6) underwent unsuccessful AngioJet thrombectomy (Boston Scientific, Marlborough, Massachusetts). The ranges of the target vessel clot length and diameter were 4.9–6.9 mm and 27–38 mm, respectively. Technical success was achieved in all patients (6/6). They (6/6) had notable acute limb ischemia (ALI) symptom relief after 1 or 2 passes of retrieval, and clinical success was achieved in all patients (6/6). No complications were observed other than reversible vasospasm in 1 patient (1/6). Amputation or death did not occur. Mechanical revascularization with the use of kissing Y-Solitaire seems to be a potentially rapid, safe, and effective modality for selected patients with refractory short-segment occlusion of ALI secondary to popliteal and infrapopliteal arteries.