PMC4374197_01
44-year old male patient with sudden onset of pain in left leg and ulcer on the toe, diagnosed with Buerger's disease. Baseline digital substraction angiography of (a and b) the popliteal region and (c) leg demonstrates abrubt thromboembolic occlusion of the popliteal artery (large white arrow in a). Typical corkscrew collateral arteries (small white arrows in b and c) and occlusion of the run-off vessels in concordance with Buerger's disease before intervention.
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F1
TAO [Figure 1].
44-year-old male patient with sudden onset of pain in left leg and ulcer on the toe, diagnosed with Buerger's disease. Digital substraction angiography of (a-d) the popliteal region and (e and f) leg during mechanical thrombectomy of the distal popliteal artery with Rotarex and reconstruction of flow to the foot. (a) Complete occlusion of the popliteal artery above the knee joint involving the trifurcation and all three lower limb artery origins (white arrows). (b) 6F Rotarex catheter (large white arrow) over the 0.018-inch wire (small white arrow). (c) Partial removal of the thrombus (open black arrows) and recanalization of the popliteal artery (black arrow) after retrograde re-entry to the true lumen following dorsalis pedis access (not shown). (d) Using the rotarex catheter, the clot was destroyed and removed totally. Patent anterior tibial artery is visible (white arrows). (e and f) Flow was reconstructed to the foot via anterior tibial artery (white arrows).
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F2
Completion angiogram showed complete exclusion of the thrombus, and straight-line flow established to the foot through the native popliteal artery and ATA [Figure 2].