Long term results after rotation angioplasty and catheter atherectomy. A retrospective analysis

Rotationangioplasty and catheter atherectomy using the TEC device was performed in 33 patients with peripheral arterial occlusive disease. Thirty-five femoral or popliteal artery occlusions could be recanalized with an initial patency of 100%. After 5 years the patients were re-evaluated by clinical examination, colour duplex scanning and in 5 cases by intra-arterial angiography. According to life table analysis there was no patent femoral or popliteal vessel after 5 years in those patients treated initially for rest pain or ischemic tissue loss. 82% of those treated for claudication had a re-occluded artery. In 5 cases a major amputation was necessary. 42% of those patients who were initially treated far disabling claudication had a severe deterioration of their functional status with development of critical ischemia. In 9 of these cases reconstructive arterial surgery was required which failed in one patient with subsequent limb loss. In the retrospective study presented patients with occlusions up to 30 cm and more were treated. Combining two interventional techniques there is a high initial success rate with poor long term results. Therefore these devices should be reserved for high risk patients who would not tolerate reconstructive vascular surgery. They should not be used in patients with claudication although even extensive occlusions can be recanalized there is an imminent danger of causing significant deterioration of the patients functional status.