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№2' 2019

SURGERY

International Medical Journal, Vol. 25., Iss. 2, 2019, P. 14−17.

FIRST EXPERIENCE OF APPLICATION OF PERCUTANEOUS MECHANICAL THROMBECTOMY IN ACUTE LIMB ISCHAEMIA

SI "V. T. Zaytsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine

The first experience of using the Rotarex endovascular device (Straub Medical AG, Switherland) for percutaneous mechanical thrombectomy in patients with acute lower limb ischemia, resulted from the thrombosis and embolism of the infraingual arteries, is presented. All the interventions on lower limb revascularization with an acute ischemia using this device proved to be technically and clinically successful. All the patients managed to achieve rechanneling of occluded segments and restoration of antegrade blood flow down the lower arterial segments to the foot. After rechanneling of the occluded arteries, in the majority of patients in arterial lumen there were pronounced stenosis lesions caused by residual thrombi and hemodynamically significant stenoses, therefore, they were additionally performed with balloon angioplasty or stenting. This allowed eliminating the residual stenosis and reaching the main blood flow of the foot. Thus, percutaneous mechanical thrombectomy with the help of the thrombectomy system Rotarex is an effective method of treating acute ischemia of lower limbs resulted from acute thrombosis and embolism. This procedure demonstrates the results comparable to traditional surgical thromboembolectomy and is accompanied with a much lower risk of perioperative complications, amputations and mortality. By reducing the need for thrombolysis, the mechanical thrombectomy thereby significantly reduces the risk of hemorrhagic complications.

Key words: acute limb ischemia, acute thrombosis, emboly, percutaneous mechanical thrombectomy.