Removal of Peripheral Arterial Occlusive Material with the Rotarex® S Device: Mechanical Atherothrombectomy

Mechanical atherothrombectomy (MATH) with the Rotarex® S (Straub Medical AG, Wangs, Switzerland) catheter is an endovascular therapeutic technique for removing fragmentable occlusive material from the lumen of peripheral vessels. It can be used as a rapid, safe and efficacious initial modality for the treatment of acute or subacute ischemia of the lower limbs, even in patients with an immediately threatened extremity and those with a contraindication for surgical and/or thrombolytic therapy. Patient placement in an intensive care unit and routine embolic prevention with a filter are not necessary. In the literature, the technical success of MATH has varied from 92% to 100%, with lower rates in subgroups with occluded bypass grafts (78%) and a crossover approach (56%). The number of secondary surgical revascularization procedures has ranged from 0% to 5.3% and the mortality rate at 30 days has varied between 0% and 1%. The 30-day clinical success has varied from 68% to 98%, secondary patency from 68% to 97.6%, amputation-free survival from 94.4% to 100%, frequency of major complications from 0% to 6.9%, major hemorrhage from 0% to 2.6% and frequency of major debulking device-related complications from 0% to 0.4%.