Endovascular popliteal thrombectomy using the self-expanding, retrievable Solitaire recanalization device.

PURPOSE: To present an initial peripheral application of the self-expanding, detachable, fully-retrievable Solitaire FR Recanalization Device for endovascular thrombectomy in the lower leg of a patient with acute peripheral limb ischemia. CASE REPORT: A 79-year-old woman with a long history of peripheral arterial occlusive disease and a femoropopliteal bypass graft presented with sudden grade IIb ischemia of the left lower leg. Conventional antegrade angiography identified total thrombotic occlusion of the tibioperoneal trunk below the distal femoropopliteal bypass anastomosis; the bypass itself was not occluded. When suction thrombectomy was unsuccessful, a 4×20-mm self-expanding, retrievable Solitaire stent was deployed. The thrombus was retrieved, with immediate recanalization of the tibioperoneal trunk and no sequela. Clinical signs of ischemia resolved, and after 6 months of follow-up, no reocclusion had occurred. CONCLUSION: Developed as a tool to retrieve clots causing acute ischemic stroke, the Solitaire FR Recanalization Device may also have a place in treating patients with acute below-the-knee thrombotic arterial occlusion in whom suction thrombectomy had failed. The Solitaire stent may be an additional endovascular option that can result in successful treatment of acute limb ischemia and avoid more expensive surgical procedures in selected cases.