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the mechanical thrombectomy has been established in acute proximal arterial occlusion. however, this method has not yet been established in the treatment of chronic thrombosis. the purpose of this study was to establish the safety and efficacy of mechanical thrombectomy for chronic thrombosis using rotarex and aspirex catheters. methods and results the chronic thrombotic lesions of the femoropopliteal arterial segment were induced in 12 pigs. in 6 pigs, rotarex or aspirex catheters were used to remove the thrombi. in 6 pigs, the same catheters were used to create a chronic thrombotic stenosis. in all animals, an occlusion-balloon catheter was positioned in the common femoral artery. thrombin (0.5 ml/kg) was injected into the catheter, and the presence of thrombi was verified by digital subtraction angiography (dsa) and computed tomography (ct). subsequently, mechanical thrombectomy was performed for 6 hours. in the first group of animals, thrombi were completely removed using the rotarex device. in the second group, the aspirex device was used for partial removal of the thrombi and creation of a chronic stenosis. in all animals, dsa and ct were repeated to evaluate the efficacy of thrombectomy. in addition, pulmonary ct was performed to rule out pulmonary embolism. finally, all animals were killed, and the iliac vein was dissected to perform macroscopic and histological examination. in the rotarex group, thrombus induction was successfully achieved in all animals as verified by dsa and ct. thrombectomy with the rotarex catheter was performed successfully in all cases. in the aspirex group, however, thrombus induction was successfully achieved in all animals as verified by dsa and ct. thrombectomy with the aspirex catheter was performed safely in all cases. pulmonary embolism was detected in two animals treated with the rotarex catheters, whereas no pulmonary emboli were seen in animals treated with the aspirex catheters. conclusionthe aspirex catheter allowed safe and effective thrombectomy in the treatment of chronic thrombosis. however, it was not possible to completely remove the thrombi from the femoropopliteal arterial segment. in contrast, rotarex catheter caused vessel perforation in all cases.more
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