Abstract
The Rotarex® (ablation and motorized aspiration catheter) is a novel device for endovascular treatment of arteries occluded by thrombi in the lower extremities. We here report two successful cases treated with Rotarex® devices.Eighty four year old male and seventy five year old male were admitted to hospital because of feet ulcers and gangrenous color changes. CT angiography showed distal superficial femoral artery occlusion in both patients. So we underwent thrombectomy, motorized aspiration by Rotarex® and balloon angioplasty. Their wound markedly recovered and limbs losses were minimal. As Rotarex® (ablation and motor aspiration) is a device which has the advantage of supplying both thrombi ablation and motor aspiration percutaneously, it is believed to play a major role in the treatment of thrombi containing peripheral arterial lesions, either new or old.
Highlights
Thrombi are a big obstacle to lower extremity endovascular procedures leading to poor clinical outcomes such as amputation, disability, even cardiovascular death
We here present two successful cases treated with this novel device
In the Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial, there were no significant differences between bypass surgery and angioplasty regarding outcomes but for recent many years, surgical revascularization strategy became superior to angioplasty revealing better overall survival and amputation free survival [2]
Summary
Thrombi are a big obstacle to lower extremity endovascular procedures leading to poor clinical outcomes such as amputation, disability, even cardiovascular death. Right and left dorsalis pedis pulse (DPP) were hardly palpable, right 1st , 4th , 5th toes were purple in color (Figure 1A) and there were 0.5 cm, 1 cm sized black and dry gangrene on right 1st, 5th toes, respectively. His right lower leg ischemia was regarded as Rutherford category 5. In blood analysis complete blood count (CBC) showed white blood cell (WBC) count of 15950 /mm hemoglobin (Hb) of Figure 1A 84-year-old male’s right foot at admission. Lower extremity CT angiography (CTA) showed total occlusion of right femoral artery and collateral vessels development (Figure 2)
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