Percutaneous Aspiration Thrombectomy with the SOFIA Catheter for Periinterventional Distal Embolization in Lower Limb...

This retrospective single-center study evaluated the effectiveness and safety of the SOFIA Catheter for percutaneous aspiration thrombectomy (PAT) in periinterventional distal embolization (DE) during lower limb endovascular revascularization.

The radiological information system was retrospectively reviewed for all DEs treated with the SOFIA Catheter between 2017 and 2024. Angiographic findings, vessel diameters, embolic origin, technical success, and complications were assessed. Reperfusion was graded using the Peripheral Arterial Reperfusion Score (PARS). PARS 2-3 was defined as the primary endpoint (angiographic technical success); conversion of PARS 1 to PARS 2-3 after adjunctive therapy as secondary success.

A total of 128 vessels in 104 patients (67 male; median age 69 years) were included. Emboli originated from acute lesions in 52% and chronic disease in 48%; in-stent restenosis was present in 17%. Primary angiographic success (PARS 2-3) was achieved in 81% (95% CI: 72.8-86.4%). After additional PTA or stenting, overall secondary success increased to 88% (95% CI: 80.7-92.2%). Thrombectomy failed in 12%. One patient required major amputation and one surgical embolectomy. No catheter-related dissections or perforations occurred. Prior AngioJet use showed an exploratory correlation with PARS 0 (r = 0.329; p < .001).

PAT using the SOFIA Catheter demonstrates high angiographic success rates and a favorable safety profile for periinterventional DE in lower limb arteries. Prior hydrodynamic thrombectomy may reduce embolus retrievability; this finding is exploratory and should be considered hypothesis-generating.

· The SOFIA Catheter enables effective aspiration in small distal vessels.. · Primary angiographic success reached 81% (95% CI: 72.8-86.4%).. · Overall success increased to 88% (95% CI: 80.7-92.2%) after adjunctive therapy.. · No catheter-related complications were observed.. · Prior AngioJet use was exploratively associated with lower retrieval success..

· Trentmann J, Aludin S, Andersson J et al. Percutaneous Aspiration Thrombectomy with the SOFIA Catheter for Periinterventional Distal Embolization in Lower Limb Revascularization. Rofo 2026; DOI 10.1055/a-2942-7381.