Document Detail


Mechanical thrombectomy in in-stent restenosis: preliminary experience at the iliac and femoropopliteal arteries with the Rotarex System.
MedLine Citation:
PMID:  20671638     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Iliac and femoropopliteal arterial stenting remains controversial due to frequent restenosis. This study aims to evaluate the efficacy of a mechanical rotational thrombectomy procedure with the Rotarex Mechanical Thrombectomy System (Straub Medical, Wangs, CH) and percutaneous transluminal angioplasty (PTA) in terms of technical success, patency rates and limb salvage.
METHODS: From May 2006 to March 2010, 32 selected patients with sub-acute or chronic in-stent restenosis at the iliac or femoropopliteal arteries were treated with a Rotarex and then PTA procedure.
RESULTS: Technical success was 100%. Intra-procedural complications included a superficial femoral artery (SFA) dissection (1), SFA (1) and external iliac (1) perforations and a groin hematoma (1). There was no incidence of embolization in this series. One patient required reintervention (3.1%); an attempted surgical bypass and amputation. Secondary reinterventions were required in 17 patients (53.1%). Limb salvage rate at 12 months was 90.6%. Primary patency at 30 days was 96.8%. Primary, primary assisted and secondary patency rates at 6 months were 75%, 75% and 89.6% and at 12 months were 58.1%, 58.1% and 75.5%, respectively. Late mortality was 18.75% at an average follow-up of 13.1 months (3-45) due to the severe disease state of these patients..
CONCLUSION: This treatment seems promising in terms of technical success and embolization risk. Reinterventions are frequently required but mid-term limb salvage rates are encouraging. Larger, randomised studies are needed to determine the cost/benefit advantage and long-term results.
Authors:
R Silingardi; V Cataldi; R Moratto; I Azzoni; J Veronesi; G Coppi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  51     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-30     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  543-50     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, University of Modena and Reggio Emilia, Baggiovara, Modena, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Amputation
Angioplasty, Balloon / adverse effects,  instrumentation*,  mortality
Arterial Occlusive Diseases / diagnosis,  mortality,  surgery,  therapy*
Constriction, Pathologic
Female
Femoral Artery / radiography,  surgery*,  ultrasonography
Humans
Italy
Kaplan-Meier Estimate
Limb Salvage
Male
Middle Aged
Pilot Projects
Popliteal Artery / radiography,  surgery*,  ultrasonography
Recurrence
Stents*
Thrombectomy / adverse effects,  instrumentation*,  mortality
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography, Doppler, Duplex
Vascular Patency

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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