title: Rotarex Mechanical Debulking in Acute and Subacute Arterial Lesions.
abstract: BACKGROUND
  Data regarding the effectiveness and safety of percutaneous mechanical thrombectomy (PMT) in contemporary routine care are scarce.
  
  
  METHODS
  Consecutive patients undergoing PMT of native lower limb acutely/subacutely occluded arteries were included.
  
  
  RESULTS
  In all, 525 consecutive patients were available for analysis with a mean age of 66.7 ± 10.7 years. Almost two-third (n = 324; 61.7%) were men with acutely (n = 211; 40.2%) or subacutely (n = 314; 59.8%) occluded lesions presenting mostly in Rutherford-Becker category (RBC): 3 (30.3%) and 4 (47.6%). Mean lesion length was 159 mm (range 22-279 mm), with moderate and severe calcification in 119 (23.3%) lesions. PMT was performed solely in 161(27.2%), PMT + balloon angioplasty in 232 (39.1%), provisional stenting in 169 (28.4%), and thrombolysis in 77 (13.9%) interventions. Procedural technical success rate was 97.7%, with improvement in RBC persisting in 74.1% of patients after 12 ± 2.4 months mean time follow-up. Overall 30 days major adverse events (MAEs) was 6.9% with a mortality rate of 1.1%. No death was directly related to the device. After 12 months, a promising overall target lesion revascularization (TLR; 10.1%), non-TLR (6.6%), and major amputation rates (2.3%) were found. One-year mortality was 8%.
  
  
  CONCLUSIONS
  Treatment with PMT resulted in clinic and hemodynamic improvement in the majority of patients, thereby reducing the need for thrombolysis in a significant proportion of patients. Prospective studies in this issue are recommended.
authors.affiliation: 1 Department of Interventional Angiology, University Hospital, University of Leipzig, Leipzig, Germany.|2 Universidade Federal do Vale do Sao Francisco, Petrolina, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Freitas
authors.affiliation: 1 Department of Interventional Angiology, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Steiner
authors.affiliation: 1 Department of Interventional Angiology, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Bausback
authors.affiliation: 3 Department of Vascular Surgery, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Branzan
authors.affiliation: 1 Department of Interventional Angiology, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Ülrich
authors.affiliation: 1 Department of Interventional Angiology, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Bräunlich
authors.affiliation: 1 Department of Interventional Angiology, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Andrej
authors.initials: A
authors.lastname: Schmidt
authors.affiliation: 1 Department of Interventional Angiology, University Hospital, University of Leipzig, Leipzig, Germany.
authors.forename: Dierk
authors.initials: D
authors.lastname: Scheinert
mesh_terms: D000208:Acute Disease; D000368:Aged; D000671:Amputation, Surgical; D018450:Disease Progression; D005260:Female; D006801:Humans; D023821:Limb Salvage; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D017131:Thrombectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome
keywords: angiography; atherectomy; endovascular procedures; rotational thrombectomy; thrombolysis