Related Experiment Videos
Infrainguinal atherectomy using the Auth Rotablator: patency rates and clinical success for 36 procedures
1Department of Vascular Surgery, Monash Medical Centre, Melbourne, Australia.
Insights
The Auth Rotablator device showed initial success in infrainguinal endoluminal atherectomy for peripheral artery disease. While results were acceptable, its comparative role against other endovascular techniques requires further definition.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Background:
- Infrainguinal occlusive arterial disease significantly impacts patient mobility and limb viability.
- Endoluminal atherectomy offers a minimally invasive approach to treating peripheral artery disease.
- The Auth Rotablator is a device used for endovascular procedures.
Purpose of the Study:
- To evaluate the efficacy and suitability of the Auth Rotablator for endoluminal atherectomy in patients with infrainguinal occlusive arterial disease.
Main Methods:
- The Auth Rotablator was utilized by two surgeons in 36 infrainguinal atherectomy procedures across 34 patients.
- Procedures addressed severe intermittent claudication, critical limb ischemia, and graft stenosis, involving both stenotic and occlusive lesions.
- Adjunctive balloon angioplasty and stenting were employed in a subset of cases.
Main Results:
- Initial technical and anatomical success was achieved in 94% of procedures.
- At a mean follow-up of 16.5 months, 61% primary and 67% secondary patency rates were observed.
- Clinical success was 56% at 12 months, with limb salvage achieved in most cases, though some required further intervention or amputation.
Conclusions:
- Atherectomy with the Auth Rotablator demonstrates acceptable outcomes for infrainguinal arterial disease.
- Further research is necessary to establish its comparative effectiveness against alternative endovascular methods.
Purpose:
To determine whether the Auth Rotablator device is suitable for endoluminal atherectomy for infrainguinal occlusive arterial disease.
Methods:
Two surgeons used the Auth Rotablator to perform 36 infrainguinal atherectomy procedures in 34 patients for severe intermittent claudication in 21, critical ischemia in 12, or graft stenosis in 3 limbs. There were 24 stenoses and 12 occlusions. Adjuvant balloon dilation was performed in 13 limbs and stenting in 5.
Results:
There was initial technical and anatomical success in 34 procedures (94%), and 24 technically successful procedures persisted at mean follow-up of 16.5 months, although 1 limb required major amputation. Three failures were due to stenosis requiring further intervention, and 9 were due to occlusion. Failure led to no further intervention in 2, amputation in 1, further endovascular intervention in 5, and open surgical reconstruction in 4 limbs. After further treatment, 29 limbs are patent with no return of symptoms, 3 are occluded, and 4 have required amputation, all for initial presentation with critical ischemia. Life-table analyses calculate primary and secondary patency rates of 61% and 67% and a clinical success rate of 56% at 12 months.
Conclusions:
Atherectomy using the Auth Rotablator provides acceptable results, but its role in comparison to other endovascular techniques is still to be defined.