Use of rotational atherectomy for reducing significant dissection in treating de novo femoropopliteal steno-occlusive disease after balloon angioplasty

• 来源期刊: 老年心脏病学杂志（英文版）
• 年，卷（期）: 2018,（4）
• 页码范围: 254-260
• 页数: 7页
• 语种: 英文
• DOI: 10.11909/j.issn.1671-5411.2018.04.006

摘要

Background Development of arterial dissection is thought to be an important key factor for bailout stenting in femoropopliteal disease.We aimed to evaluate the difference in dissection rate and outcomes between the treatment group with rotational atherectomy and without it.Methods From January 2011 to October 2016,we compared the angiography after balloon angioplasty (BA) of denovo,femoropopliteal,stenoocclusive lesions whether they were treated by rotational atherectomy prior to the BA or not.Fiftynine lesions (8 occlusions;3involving popliteal segment;lesion length:86.3 ± 66.8 rnm) in 44 patients (29 males;mean age 66.9 ± 9.7 years) were enrolled for this review.Results Forty-two lesions were treated using rotational atherectomy,prior to BA while 17 were recanalized firstly by BA.Clinical and lesion characteristics were not different between the groups.However,the rate of significant arterial dissection (type C to F) was lower in the atherectomy group (88.2％ vs.42.9％;P =0.001).In multivariate analysis,use of the atherectomy device was the only risk factor for prevention of development of significant dissection (P =0.013;OR =0.12;95％ CI:0.0250.642).Patients were treated either by the angioplasty alone,drug coated balloon or stent insertion.There was lower trend in target vessel revascul arization and primary patency toward the atherectomy group (low rank P =0.108 and 0.166),however secondary patency was significantly better (low rank P =0.001).Conclusions Rotational atherec tomy before BA reduced the rate of significant dissection and therefore,might be a valuable option for minimizing need of bailout stenting.