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A Journal on Cardiac, Vascular and Thoracic Surgery

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The Journal of Cardiovascular Surgery 1998 February;39(1):15-8

language: English

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

Kolvenbach R., Strosche H.

From the Department of Vascular Surgery, Augusta Hospital, Duesseldorf, Germany


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.

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