Clinical analysis of Rotarex percutaneous mechanical thrombectomy for treatment of lower extremity artificial bypass occlusion
10.3760/cma.j.cn115396-20220922-00306
- VernacularTitle:Rotarex经皮机械血栓切除系统治疗下肢动脉人工血管转流术后移植物闭塞的临床分析
- Author:
Zhao LIU
1
;
Hai FENG
;
Xueming CHEN
;
Hongzhi YU
;
Renming ZHU
;
Xiang GAO
;
Zhe ZHANG
;
Bin LIU
Author Information
1. 首都医科大学附属北京友谊医院血管外科，北京 100050
- Keywords:
Thrombectomy;
Blood vessel prosthesis;
Graft occlusion, vascular;
Lower extremity artery bypass;
Rotarex system
- From:
International Journal of Surgery
2022;49(11):752-756,C1
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy of Rotarex percutaneous mechanical thrombectomy(PMT) for treatment of lower extremity arterial graft occlusion.Methods:The clinical data of 19 patients with lower extremity arterial bypass occlusion admitted to our hospital from January 2016 to December 2020 were retrospectively analyzed. All patients were treated with Rotarex-based endovascular therapy. After 12 months follow-up, the clinical features, surgical outcomes and follow-up data were analyzed to identify effectiveness and safety of the therapy. Independent sample t test was used to analyze the measurement data of continuous normal distribution which were expressed as mean±standard deviation( ± s), enumeration data were expressed as number and percentage, and the comparison between groups were analyzed by chi-square test. Results:A technical success rate of 100% was demonstrated. Rotarex combined with catheter directed thrombolysis was performed in 2 cases, Rotarex combined with percutaneous transluminal angioplasty (PTA) was performed in 9 cases. Rotarex combined with stent implantation was performed in 8 patients. The Ankle brachial index significantly increased (0.82±0.14 vs 0.47±0.11, P<0.05). Critical limb ischemia (Rutherford class 4 or higher) improved significantly (0 case vs 9 cases, P<0.05). Distal embolism occurred in 1 patient and acute myocardial infarction occurred in 1 patient. There was no vascular rupture, haemorrhage, infection, pseudoaneurysm, death and amputation. Kaplan-Meier survival analysis revealed 12-month primary patency rate and freedom from clinically driven target lesion revascularization was 78.9% and 89.5% respectively. Conclusion:Rotarex-based endovascular therapy is a safe and effective treatment for graft occlusion after lower extremity arterial prosthesis bypass with high patency rate and few complications.
