[Percutaneous mechanical thrombectomy by means of rotational thrombectomy. Current study situation]

Abstract

Acute and subacute ischemia of the limbs is still one of the most frequent reasons for amputation. There are different therapy options for reperfusion therapy including balloon thrombectomy, local lysis and rotational thrombectomy. Balloon thrombectomy, the standard surgical treatment, has proven an effective tool for the treatment of acute vascular obstructions. Nevertheless technical problems and complications can occur. Localized lysis on the other hand could be time - consuming and cost intensive, requiring intensive care monitoring and reangiograms. To achieve a successful result, at least one lower limb artery or major collateral has to be reopened to establish a sufficient situation. During the last years considerable advances have been made in endovascular interventions for the treatment of acute and subacute limb ischemia. The Straub Rotarex is one of the modern peripheral mechanical thrombectomy device, which combines mechanical thrombus fragmentation and removal of the material using negative pressure. There are different clinical and experimental studies, which have shown promising results in restoring blood flow to the occluded vessels. Studies mainly exist for the lower extremities. Some case reports showed effective treatment of the subclavian and axillary arteries. The advantages of the Rotarex system is simple handling, a short intervention time and the avoidance of lytic substances with consequent reduced risk of hemorrhage complications. In this article an overview about the main Rotarex studies is given which analyzed the results of percutaneous rotational thrombectomy in patients with subacute an acute thrombotic occlusions in peripheral arteries.