Wissgott C, Kamusella P, Andresen R
Institut für Diagnostische und Interventionelle Radiologie/Neuroradiologie, Westküstenklinikum Heide - Akademisches Lehrkrankenhaus der Universitäten Kiel, Lübeck und Hamburg.
Rofo. 2011 Oct;183(10):939-44. doi: 10.1055/s-0031-1281634. Epub 2011 Sep 5.
The main problem with the treatment of arterial stenoses by percutaneous transluminal angioplasty (PTA) or stent implantation is the relatively high restenosis rate. The objective of this prospective single-center study was to evaluate a mechanical rotational catheter (Straub Rotarex®) for its safety and efficacy in the treatment of in-stent reocclusions.
78 patients with a mean age of 64.2 ± 8.3 years (42 - 85) were treated by means of the Rotarex® catheter. All patients had in-stent reocclusions of the femoropopliteal arteries. The preinterventional Rutherford stage was on average 3.36 (2 - 5). The mean lesion length was 14.7 cm (6 - 30 cm). The ankle-brachial index (ABI) was determined prior to and after the intervention, as well as after 12 months. An additional follow-up was performed using color-coded duplex sonography.
The technical success rate was 97.4 % (76 / 78). In 52 / 76 patients (68.4 %), adjunctive balloon dilation was performed, and 8 / 76 (10.5 %) patients required a stent implantation. Clinically, there was an increase in the ankle-brachial index from 0.61 ± 0.17 to 0.85 ± 0.15 post-interventionally. After 12 months, it was 0.78 ± 0.16, and the average Rutherford stage fell to 1.65 (1 - 3). During the follow-up observation period, there were 14 (18.4 %) restenoses. Two dissections after Rotarex were recorded as peri-interventional complications. No distal embolizations were observed. There were no amputations or deaths during the entire period of the study.
The recanalization of in-stent reocclusions of femoropopliteal arteries using the Rotarex® system is safe and effective. The low rate of restenosis at 12 months appears to be promising.
经皮腔内血管成形术（PTA）或支架植入术治疗动脉狭窄的主要问题是再狭窄率相对较高。这项前瞻性单中心研究的目的是评估一种机械旋转导管（Straub Rotarex®）治疗支架内再闭塞的安全性和有效性。
78例平均年龄为64.2±8.3岁（42 - 85岁）的患者接受了Rotarex®导管治疗。所有患者均有股腘动脉支架内再闭塞。介入治疗前的卢瑟福分级平均为3.36（2 - 5级）。平均病变长度为14.7厘米（6 - 30厘米）。在干预前后以及12个月后测定踝肱指数（ABI）。使用彩色编码双功超声进行额外的随访。
技术成功率为97.4%（76/78）。52/76例患者（68.4%）进行了辅助球囊扩张，8/76例患者（10.5%）需要植入支架。临床上，干预后踝肱指数从0.61±0.17增加到0.85±0.15。12个月后，为0.78±0.16，平均卢瑟福分级降至1.65（1 - 3级）。在随访观察期内，有14例（18.4%）发生再狭窄。记录到Rotarex术后有2例夹层作为围介入期并发症。未观察到远端栓塞。在整个研究期间没有截肢或死亡病例。
使用Rotarex®系统再通股腘动脉支架内再闭塞是安全有效的。12个月时较低的再狭窄率似乎很有前景。
