Percutaneous mechanical thrombectomy using Rotarex catheter in peripheral artery occlusion diseases – Experience from a single center

Liu, Jinbo; Li, Tianrun; Huang, Wei; Zhao, Ning; Liu, Huan; Zhao, Hongwei; Wang, Hongyu

doi:10.1177/1708538118813239

Cited by 10 publications

(12 citation statements)

References 15 publications

(18 reference statements)

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“…In previous studies that used the Rotarex catheter to treat ALI and SLI, 13–24 final technical success varied from 92% to 100% in studies with target occlusions in the infra-aortic arteries, 14 femoropopliteal segment, 13,15–18 and femoropopliteal bypass grafts 19,20 despite having higher proportions of SLI and shorter lesions than the present study. Lower technical success was reported in subgroups with occluded bypass grafts (78%) and those treated via a crossover approach (56%).…”

Section: Discussioncontrasting

confidence: 60%

Prospective Single-Arm Trial of Endovascular Mechanical Debulking as Initial Therapy in Patients With Acute and Subacute Lower Limb Ischemia: One-Year Outcomes

et al. 2019

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Purpose: To report the results of a prospective, single-arm study to establish whether the initial treatment of acute or subacute limb ischemia (ALI and SLI, respectively) can be accomplished successfully using endovascular mechanical debulking of the target vessels to avoid the risks associated with thrombolysis and/or open surgery. Materials and Methods: From April 2009 to April 2015, 316 consecutive patients (mean age 70.9±12 years; 184 men) with ALI (202, 63.9%) or SLI (114, 36.1%) were enrolled; the only exclusion criterion was irreversible ischemia. The ALI group included 146 (72.3%) participants with category IIb ischemia and 56 (27.7%) with category IIa. Critical limb ischemia was diagnosed in 74 (64.9%) of the 114 patients with SLI. Target occlusions of thrombotic (n=256) or embolic (n=60) origin were located in the femoropopliteal segment (n=231), prosthetic or venous femoropopliteal bypass grafts (n=75), and the aortoiliac segment (n=35). The mean occlusion length was 22.9±14.8 cm. Results: The overall technical success (residual stenosis ≤30%) was 100% after debulking and adjunctive techniques (aspiration, dilation, stenting) at the level of the target lesions. No open surgical or thrombolytic modalities were necessary to bypass or recanalize the target vessels, and no death occurred in association with target occlusion therapy. Additional infrapopliteal interventions were performed in 195 (61.7%) patients (adjunctive thrombolysis in 29) to treat acute, subacute, and chronic lesions. Minor complications directly related to the debulking procedure occurred in 26 (8.2%) patients. Serious complications occurred in 11 (3.5%) patients, including hemorrhage in 8 (2.5%) patients (associated with infrapopliteal thrombolysis in 5). At 30 days, primary and secondary patency rates were 94.3% and 97.2%, respectively; mortality was 0.3% (1 fatal intracranial hemorrhage after adjunctive thrombolysis). Of 229 patients eligible for 1-year follow-up, amputation-free survival was estimated to be 87.4% in 199 patients with available data. Conclusion: In this all-comers study, mechanical debulking with the Rotarex alone or with adjunctive techniques is feasible as a primary therapy for occluded supratibial vessels in patients with ALI or SLI.

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Section: Discussioncontrasting

confidence: 60%

Prospective Single-Arm Trial of Endovascular Mechanical Debulking as Initial Therapy in Patients With Acute and Subacute Lower Limb Ischemia: One-Year Outcomes

et al. 2019

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“…Main data regarding the utility of MATH using the Rotarex S device in the management of acute and subacute lower limb occlusive disease and its potential contribution in prolonging the durability of endovascular revascularization are coming mainly from retrospective studies ( Table 1) (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). Looking at the literature, we identified 16 clinical studies, which evaluated MATH using the Rotarex S device as a primary treatment during revascularization interventions in patients with peripheral arterial occlusive disease in iliac, femoral, and/or popliteal arteries.…”

Section: Current Role Of "Math" Using Rotarex S Device In Peripheral mentioning

confidence: 99%

“…The majority were retrospective cohorts with a total number of 1,844 patients having had Rotarex S MATH as part of their treatment. Out of 16 studies, 8 studies investigated the role of Rotarex S MATH for native vessel occlusion (12)(13)(14)(15)(16)(17)(18)(19), 3 studies used Rotarex S MATH for in-stent restenosis/occlusion (6, 20, 21), 2 studies tested Rotarex S MATH for bypass thrombosis (1,10), and 3 studies evaluated Rotarex S MATH for mixed populations combining the three previous indications (11,22,23).…”

Section: Current Role Of "Math" Using Rotarex S Device In Peripheral mentioning

confidence: 99%

“…Eight retrospective studies reported results regarding the role of Rotarex S MATH in peripheral acute occlusive disease in native vessels, investigating a total number of 1,095 patients (12)(13)(14)(15)(16)(17)(18)(19). The largest study was reported by Freitas et al, investigating 525 consecutive patients with a mean age of 66.7 ± 10.7 years (14).…”

Section: Rotarex S "Math" For Native Vessel Occlusionmentioning

confidence: 99%

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Percutaneous Rotational Mechanical Atherectomy Plus Thrombectomy Using Rotarex S Device in Patients With Acute and Subacute Lower Limb Ischemia: A Review of Safety, Efficacy, and Outcomes

Loffroy¹,

Falvo²,

Galland³

et al. 2020

Front. Cardiovasc. Med.

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Acute and subacute ischemia of lower limbs is associated with high risk of amputation and potential severe life-threatening complications. Despite a lack of clear therapeutic recommendations, surgical treatments such as thrombectomy or bypass and/or catheter-directed thrombolysis (CDT) have been first-line procedures in both acute and subacute limb ischemia, but each therapy may lead to significant morbidity and mortality. Such situations demand fast restoration of appropriate flow to preclude limb loss and other complications. Percutaneous mechanical atherectomy plus thrombectomy (MATH) represents a minimally invasive approach for quickly recanalizing thrombus-containing lesions whatever the age of thrombus. Indeed, many chronic patients can present with critical limb ischemia, with thrombus-containing occlusive lesions triggered by underlying atherosclerotic disease. MATH offers various advantages over surgery and CDT, with lower invasiveness, faster recanalization, and the possibility to immediately treat the underlying lesions, with a lower rate of bleeding complications and no need for intensive care unit stay. Currently, several mechanical thrombectomy devices are offered as an alternative therapy and can be divided into pure rotational MATH systems and rheolytic thrombectomy devices. The only pure rotational MATH device currently available on the market is the Rotarex S device. We aimed to review contemporary clinical data regarding the safety, efficacy, and outcomes of MATH therapy using Rotarex S catheter in acute and subacute thrombus-containing arterial lesions of lower limbs. Future perspectives of Rotarex S MATH treatment and cost-effectiveness of its routine use will be also discussed.

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“…Our previous study also showed the effectiveness and safety of the Rotarex system. 15 A study on 200 Chinese patients with severe femoropopliteal lesions showed that DCBs were superior to PTA at a 24-month follow-up and the safety of DCBs was equivalent to that of PTA. 16 Another study involving the popliteal artery showed that the primary patency was 77.4% at a median of 12.2 months.…”

Section: Discussionmentioning

confidence: 99%

Drug-coated balloons used in peripheral artery disease: experience from a single center

Wang

Huang

et al. 2020

J Int Med Res

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Objective This retrospective single-center study aimed to analyze immediate and follow-up results of using drug-coated balloons (DCBs) for treating peripheral arterial disease. Methods In this study, we identified a total of 75 patients who underwent DCB therapy at our institution. The ankle–brachial index (ABI) was measured before and after intervention. Intermittent claudication and whether there was healing of ulcers were determined by telephone. Results The cohort consisted of 56 men and 19 women aged 38 to 87 years (68 ± 12 years). Twenty-three patients had Rutherford grade III, 15 had Rutherford grade IV, and 37 had Rutherford grade V. Seventeen patients had stents and 18 had the Rotarex system used. The postoperative ABI was significantly greater than the preoperative ABI (0.911 ± 0.173 vs 0.686 ± 0.249). Good results for treatment were obtained. Intermittent claudication and rest pain did not occur in subjects with Rutherford grades III and IV during follow-up. The amputation rate was 4.1% among all patients using DCB therapy during follow-up. Conclusions DCB therapy is safe and effective for treating peripheral arterial disease in real-world patients. Future prospective studies on this issue are recommended.

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Percutaneous mechanical thrombectomy using Rotarex catheter in peripheral artery occlusion diseases – Experience from a single center

Cited by 10 publications

References 15 publications

Prospective Single-Arm Trial of Endovascular Mechanical Debulking as Initial Therapy in Patients With Acute and Subacute Lower Limb Ischemia: One-Year Outcomes

Prospective Single-Arm Trial of Endovascular Mechanical Debulking as Initial Therapy in Patients With Acute and Subacute Lower Limb Ischemia: One-Year Outcomes

Percutaneous Rotational Mechanical Atherectomy Plus Thrombectomy Using Rotarex S Device in Patients With Acute and Subacute Lower Limb Ischemia: A Review of Safety, Efficacy, and Outcomes

Drug-coated balloons used in peripheral artery disease: experience from a single center

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