@article{QIMS33612,
author = {Romaric Loffroy and Nizam Edriss and Gilles Goyault and Alain Chabanier and Jean-Marc Pernes and Antoine Sauguet and Mehdi Touil and Bernard Woerly and Dionyssios Pongas and Olivier Chevallier and Nicolas Falvo and Christophe Galland and Marco Midulla and Nathalie Garnier and Marie-Pierre Guenfoudi and Mathieu Boulin and Serge Aho-Gléglé and Stéphanie Bost},
title = {Percutaneous mechanical atherothrombectomy using the Rotarex ® S device in peripheral artery in-stent restenosis or occlusion: a French retrospective multicenter study on 128 patients},
journal = {Quantitative Imaging in Medicine and Surgery},
volume = {10},
number = {1},
year = {2019},
keywords = {},
abstract = {Background: To ascertain the safety and mid-term outcomes of Rotarex®S rotational atherectomy plus thrombectomy device (Straub Medical AG, Wangs, Switzerland) with or without adjunctive treatment (e.g., percutaneous transluminal angioplasty, PTA/drug-coated balloon, DCB/stenting) in patients with in-stent restenosis (ISR) or occlusion in the iliac and/or infrainguinal arteries.
Methods: French multicenter retrospective study of all patients treated by in-stent percutaneous mechanical debulking (PMD) of the lower limbs with Rotarex®S device between January 2013 and November 2018.
Results: The cohort consisted of 128 patients (88 men and 40 women), aged 39–94 years (mean, 66.7±12 years). All patients presented with cardio-vascular risk factors. Overall, 51.5% of patients had critical limb ischemia. The study demonstrated a technical success of 96.9% in the population with PMD and adjunctive PTA (95/128, 74.2%) or adjunctive DCB (16/128, 12.5%) or both (13/128, 10.2%). At 12-months follow-up, the primary clinical success/patency rate was 92.3% and the secondary clinical success/patency rate was 91.4%. Rate of limb salvage was 93.7%. Overall 32 (25%) reinterventions were reported with mean time from Rotarex®S treatment to reintervention of 7.1±8.2 months. Target lesion revascularization (TLR) was 19.5% (25/128). Seven (5.5%) patients developed distal embolism that responded to endovascular treatment. At mean follow-up, major adverse events (MAE) observed were death (18/128, 14.1%), myocardial infarction (MI) (9/128, 7.0%), stroke (2/128, 1.6%) and renal failure (3/128, 2.3%).
Conclusions: Recanalization with Rotarex®S rotational atherectomy plus thrombectomy device is a practical choice for arterial ISR/occlusions of the iliac and/or infrainguinal arteries, regardless of the age of the thrombus, with satisfying TLR. Only adjunctive PTA is often necessary to further improve the recanalization.},
issn = {2223-4306}, url = {https://qims.amegroups.org/article/view/33612}
}