Treatment of infrapopliteal occlusive disease by high-speed rotational atherectomy: Initial and mid-term results

Citation
T. Jahnke et al., Treatment of infrapopliteal occlusive disease by high-speed rotational atherectomy: Initial and mid-term results, J VAS INT R, 12(2), 2001, pp. 221-226
Citations number
36
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging
Journal title
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
ISSN journal
1051-0443 → ACNP
Volume
12
Issue
2
Year of publication
2001
Pages
221 - 226
Database
ISI
SICI code
1051-0443(200102)12:2<221:TOIODB>2.0.ZU;2-W
Abstract
PURPOSE: To assess the effectiveness and patency rates of high-speed rotati onal atherectomy (HSRA) for the treatment of infrapopliteal arterial occlus ive disease. MATERIAL AND METHODS: During an 18-month period, a total of 19 infrapoplite al lesions in 15 consecutive patients were treated primarily by HSRA with u se of the Rotablator device. Patients were followed up with documentation o f clinical symptoms, standardized treadmill exercise, and Doppler sonograph y at 1, 3, and 6 months. Control angiography was performed 6 months after p rimary treatment. RESULTS: HSRA was initially successful in 14 of 15 patients, yielding an in itial technical success rate of 94%. Percutaneous treatment induced an impr ovement of the ankle-brachial index (ABI) from 0.6 +/- 0.09 to 0.86 +/- 0.2 after intervention (P <.0001). Doppler analysis showed a mean ABI of 0.85 +/- 0.2 (P <.001) at 1 month, 0.72 +/- 0.2 (P =.012) at 3 months, and 0.7 /- 0.2 (P =.08) at 6 months after initial therapy. Although six patients we re lost to follow-up at various times, control angiography at 6 months was carried out in nine of 15 patients, allowing direct assessment of 12 of 19 treated lesions. Among six high-grade restenoses and five total occlusions in the treated vascular segments, only one arterial lumen (of 12) remained patent without presenting a hemodynamically relevant restenosis. These resu lts led to termination of the study. CONCLUSION: Although HSRA for the treatment of infrapopliteal occlusive dis ease yields a very high initial technical success rate, mid-term results ar e extremely poor. Therefore, HSRA cannot be recommended for primary treatme nt of this type of lesion.