LONG-TERM RESULTS AFTER ROTATION ANGIOPLASTY AND CATHETER ATHERECTOMY- A RETROSPECTIVE ANALYSIS

Rotationangioplasty and catheter atherectomy using the TEC device was performed in 33 patients with peripheral arterial occlusive disease. T hirty-five femoral or popliteal artery occlusions could be recanalized with an initial patency of 100%. After 5 years the patients were re-e valuated by clinical examination, colour duplex scanning and in 5 case s by intra-arterial angiography. According to life table analysis ther e was no patent femoral or popliteal vessel after 5 years in those pat ients 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 initial ly treated far disabling claudication had a severe deterioration of th eir functional status with development of critical ischemia. In 9 of t hese cases reconstructive arterial surgery was required which failed i n one patient with subsequent limb loss. In the retrospective study pr esented patients with occlusions up to 30 cm and more were treated. Co mbining two interventional techniques there is a high initial success rate with poor long term results. Therefore these devices should be re served for high risk patients who would not tolerate reconstructive va scular surgery. They should not be used in patients with claudication although even extensive occlusions can be recanalized there is an immi nent danger of causing significant deterioration of the patients funct ional status.