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Related Experiment Videos

Percutaneous peripheral atherectomy using the rotablator: a single-center experience

M Henry1, M Amor, G Ethevenot

  • 1Polyclinique d'Essey-les-Nancy, France.

Journal of Endovascular Surgery : the Official Journal of the International Society for Endovascular Surgery
|February 1, 1995
PubMed
Summary

Rotablator therapy effectively treats complex peripheral vascular lesions, particularly in distal leg arteries, showing high technical success rates. While restenosis can occur, especially in longer lesions, this rotational ablation technique is valuable for improving vessel patency.

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Endovascular Therapy

Background:

  • Peripheral vascular disease (PVD) affects numerous patients, often presenting with complex lesions.
  • Percutaneous transluminal angioplasty (PTA) is a common treatment, but complex and calcified lesions pose challenges.
  • Rotational atherectomy offers an alternative for debulking lesions prior to or in conjunction with PTA.

Purpose of the Study:

  • To evaluate the efficacy and safety of percutaneous peripheral rotational ablation using the Rotablator device.
  • To assess the role of Rotablator in treating complex peripheral vascular lesions, including those below the knee and at bifurcations.

Main Methods:

  • A prospective study treated 150 symptomatic patients with 212 complex peripheral vascular lesions using Rotablator.

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  • Lesions were characterized by location, length, calcification, and bifurcation involvement.
  • Complementary percutaneous transluminal angioplasty (PTA) was utilized as needed.

    • Main Results:

    • Rotablator therapy significantly reduced stenosis from 81% to 18%.
    • Technical success was high (97%), with 37 intraprocedural complications.
    • At a mean follow-up of 14.4 months, 76% of lesions remained patent, with a 24% restenosis rate, higher for longer lesions (>7 cm) and femoropopliteal locations.

    Conclusions:

    • Percutaneous peripheral rotational ablation is highly effective for complex distal leg lesions.
    • The indications for Rotablator can be expanded to complex lesions up to 6 cm.
    • This technique may improve long-term patency of subsequent PTA and bypass grafts.