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

T Jahnke1, J Link, S Müller-Hülsbeck

  • 1Klinik für Diagnostiche Radiologie, Christian-Albrechts-Universität zu Kiel, Uniklinik Regensburg, Germany.

Journal of Vascular and Interventional Radiology : JVIR
|March 27, 2001
PubMed

Insights

High-speed rotational atherectomy (HSRA) showed high initial success for infrapopliteal arterial disease but poor mid-term patency. HSRA is not recommended as a primary treatment for these lesions.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Peripheral Artery Disease

Background:

  • Infrapopliteal arterial occlusive disease significantly impacts patient mobility and quality of life.
  • Effective treatment strategies for infrapopliteal lesions are crucial for limb salvage and symptom relief.

Purpose of the Study:

  • To evaluate the effectiveness and patency rates of high-speed rotational atherectomy (HSRA) in treating infrapopliteal arterial occlusive disease.
  • To determine the mid-term outcomes of HSRA in this patient population.

Main Methods:

  • A total of 19 infrapopliteal lesions in 15 patients were treated with HSRA using the Rotablator device.
  • Patients underwent clinical assessment, treadmill exercise, and Doppler sonography at 1, 3, and 6 months post-intervention.
  • Control angiography was performed at 6 months to assess lesion patency.

Main Results:

  • HSRA achieved an initial technical success rate of 94% (14 of 15 patients).
  • Ankle-brachial index (ABI) improved significantly post-intervention but showed a declining trend at 6 months.
  • Only one of 12 assessed lesions remained patent without significant restenosis at 6 months, leading to study termination.

Conclusions:

  • HSRA demonstrates a high initial technical success rate for infrapopliteal occlusive disease.
  • However, the mid-term patency rates are unacceptably poor.
  • HSRA is not recommended for the primary treatment of infrapopliteal arterial occlusive disease.
Abstract

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