Introduction

Peripheral artery disease (PAD) is usually treated with conventional or endovascular surgery guided by angiography or endovascular ultrasound. Although there are reports on the use of the Rotarex® atherectomy and mechanical thrombectomy systems and/or duplex ultrasound (DU) as separate guides for thrombectomies, the combination of both devices offers a greater advantage as this option has a good success rate and could be used in the management of different types of conditions.

Case presentation

Two cases of patients with a history of infrapopliteal stent are reported. They visited the emergency department of a university hospital in Bucaramanga (Colombia) due to intermittent claudication, dyschromia, and gait disturbance (ankle-brachial index on physical examination of 0.3 and 0.6). Both patients presented with stent thrombosis detected by means of arterial duplex and underwent angioplasty using the Rotarex® system combined with DU, achieving satisfactory clinical and hemodynamic outcomes in the postoperative period. The patients were discharged 4 and 6 days after the procedure, and there was no post-discharge follow-up in either case.

Conclusions

This combined procedure is a viable, real, and cost-effective alternative in comorbid patients at high risk of PAD. The implementation by different surgical groups of this type of strategy is recommended to carry out studies with greater statistical power for the analysis of results and to obtain reproducible conclusions on success rates, patency, and limb salvage.

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