Rotarex ® S rotational atherectomy combined with drug-coated balloon angioplasty for treating femoropopliteal artery in-stent restenosis

• Published in: Journal of cardiothoracic surgery 2024-12, Vol.19 (1), p.653-8
• Main Authors: Wang, Hui, Wu, Sensen, Meng, Wenzhuo, Pan, Dikang, Ning, Yachan, Guo, Jianming, Guo, Lianrui, Gu, Yongquan
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angioplasty; Angioplasty, Balloon - methods; Atherectomy - methods; Cardiac patients; Care and treatment; Clopidogrel; Coated Materials, Biocompatible; Drug-coated balloon (DCB); Endarterectomy; Female; Femoral Artery - surgery; Femoropopliteal artery; Health aspects; Humans; In-stent restenosis (ISR); Male; Medical research; Medicine, Experimental; Middle Aged; Peripheral Arterial Disease - surgery; Popliteal Artery - surgery; Retrospective Studies; Rotational atherectomy (RA); Stent (Surgery); Stents; Transluminal angioplasty; Treatment Outcome; Vascular Patency
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-024-03164-1

This study aimed to analyze the safety and mid-term outcomes of a hybrid treatment method combining rotational atherectomy (RA) with drug-coated balloon (DCB) angioplasty in patients with femoropopliteal artery in-stent restenosis (ISR). This single-center retrospective study enrolled patients from January 2018 to March 2022 who had femoropopliteal artery in-stent restenosis treated by RA and DCB. Preoperative demographics, operative details, and postoperative 12-month follow-up outcomes were analyzed statistically. 38 consecutive patients (31 men; mean age 69.55 ± 9.18 years, range 54-91 years) with Tosaka II (n = 8) and III (n = 30) ISR were treated with RA Most patients had a high prevalence of typical vascular comorbidities. Overall, 50% of patients had chronic limb-threatening ischemia, and the average lesion length was 155.0 ± 54.8 mm. The primary patency rate, assessed by duplex ultrasound at 12 months, was 86.7%; 7.9% (3/38) of patients underwent target lesion revascularization (TLR). The overall mortality rate was 2.6% (1/38), and the ulcer healing rate reached 83.3% (5/6), with none of these patients requiring amputation. Subgroup analysis based on target lesion length (≥ 200 mm) showed that the 12-month primary patency rate was 75.0% for the ≥ 200 mm group and 95.5% for the