Cargando…

Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial

Background: Treatment of calcified popliteal artery lesions represents an ongoing challenge for vascular specialists. Biomechanical forces of external compression, torsion and elongation that occur with locomotion in the popliteal segment can lead to stent fractures and occlusions. The aim of our st...

Descripción completa

Detalles Bibliográficos
Autores principales: Donas, Konstantinos P., Psyllas, Anastasios, Pitoulias, Apostolos G., Kazemtash, Majid, Dahi, Firouza, Abu Bakr, Nizar, Korosoglou, Grigorios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10144177/
https://www.ncbi.nlm.nih.gov/pubmed/37109133
http://dx.doi.org/10.3390/jcm12082797
_version_ 1785034039912038400
author Donas, Konstantinos P.
Psyllas, Anastasios
Pitoulias, Apostolos G.
Kazemtash, Majid
Dahi, Firouza
Abu Bakr, Nizar
Korosoglou, Grigorios
author_facet Donas, Konstantinos P.
Psyllas, Anastasios
Pitoulias, Apostolos G.
Kazemtash, Majid
Dahi, Firouza
Abu Bakr, Nizar
Korosoglou, Grigorios
author_sort Donas, Konstantinos P.
collection PubMed
description Background: Treatment of calcified popliteal artery lesions represents an ongoing challenge for vascular specialists. Biomechanical forces of external compression, torsion and elongation that occur with locomotion in the popliteal segment can lead to stent fractures and occlusions. The aim of our study was to assess the procedural success rate of atherectomy in combination with balloon angioplasty for isolated calcified popliteal artery lesions. Methods: Between January 2020 and December 2022, 62 patients with isolated atherosclerotic lesions of the popliteal artery underwent endovascular treatment by use of rotational atherectomy (Phoenix, Philips USA, (subgroup A) or Jetstream, Boston USA, (subgroup B), atherectomy systems) and additional balloon angioplasty in two vascular centers. The primary outcome measures were: 1. periprocedural clinical and technical success (<30% residual stenosis and no need for bailout stenting due to flow-limiting dissection) and 2. postprocedural increase in the ankle brachial index of more than 0.1. Results: The overall rate of bailout stenting was 4.8%, whereas the procedural success rate was 98.4%. The rate of procedural complications included 3.7% and 5.7% peripheral embolizations in the subgroups A and B, respectively, and no vessel perforations were noted. All embolizations were successfully treated by catheter aspiration or capture in the pre-treatment placed filter system. In addition, 1 (3.7%) pseudoaneurysm in the groin was reported in subgroup A and treated by surgical means. Median ABI of the affected limbs improved from 0.55 (0.2) to 0.70 (0.2) in subgroup A and from 0.50 (0.2) to 0.95 (0.1) in subgroup B (DABI of 0.15 versus 0.45, p < 0.001). Conclusions: The combination of rotational atherectomy and balloon angioplasty in the popliteal artery showed reproducible outcomes in 2 centers, with low incidence of complications and low rates of bail-out stenting. These findings may contribute to more liberal use of such devices especially in segments with high risk for stent factures and occlusions.
format Online
Article
Text
id pubmed-10144177
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-101441772023-04-29 Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial Donas, Konstantinos P. Psyllas, Anastasios Pitoulias, Apostolos G. Kazemtash, Majid Dahi, Firouza Abu Bakr, Nizar Korosoglou, Grigorios J Clin Med Article Background: Treatment of calcified popliteal artery lesions represents an ongoing challenge for vascular specialists. Biomechanical forces of external compression, torsion and elongation that occur with locomotion in the popliteal segment can lead to stent fractures and occlusions. The aim of our study was to assess the procedural success rate of atherectomy in combination with balloon angioplasty for isolated calcified popliteal artery lesions. Methods: Between January 2020 and December 2022, 62 patients with isolated atherosclerotic lesions of the popliteal artery underwent endovascular treatment by use of rotational atherectomy (Phoenix, Philips USA, (subgroup A) or Jetstream, Boston USA, (subgroup B), atherectomy systems) and additional balloon angioplasty in two vascular centers. The primary outcome measures were: 1. periprocedural clinical and technical success (<30% residual stenosis and no need for bailout stenting due to flow-limiting dissection) and 2. postprocedural increase in the ankle brachial index of more than 0.1. Results: The overall rate of bailout stenting was 4.8%, whereas the procedural success rate was 98.4%. The rate of procedural complications included 3.7% and 5.7% peripheral embolizations in the subgroups A and B, respectively, and no vessel perforations were noted. All embolizations were successfully treated by catheter aspiration or capture in the pre-treatment placed filter system. In addition, 1 (3.7%) pseudoaneurysm in the groin was reported in subgroup A and treated by surgical means. Median ABI of the affected limbs improved from 0.55 (0.2) to 0.70 (0.2) in subgroup A and from 0.50 (0.2) to 0.95 (0.1) in subgroup B (DABI of 0.15 versus 0.45, p < 0.001). Conclusions: The combination of rotational atherectomy and balloon angioplasty in the popliteal artery showed reproducible outcomes in 2 centers, with low incidence of complications and low rates of bail-out stenting. These findings may contribute to more liberal use of such devices especially in segments with high risk for stent factures and occlusions. MDPI 2023-04-10 /pmc/articles/PMC10144177/ /pubmed/37109133 http://dx.doi.org/10.3390/jcm12082797 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Donas, Konstantinos P.
Psyllas, Anastasios
Pitoulias, Apostolos G.
Kazemtash, Majid
Dahi, Firouza
Abu Bakr, Nizar
Korosoglou, Grigorios
Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial
title Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial
title_full Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial
title_fullStr Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial
title_full_unstemmed Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial
title_short Periprocedural Outcomes of Rotational Atherectomy-Assisted Balloon Angioplasty in Isolated Atherosclerotic Popliteal Artery Lesions: The ISO-POP Trial
title_sort periprocedural outcomes of rotational atherectomy-assisted balloon angioplasty in isolated atherosclerotic popliteal artery lesions: the iso-pop trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10144177/
https://www.ncbi.nlm.nih.gov/pubmed/37109133
http://dx.doi.org/10.3390/jcm12082797
work_keys_str_mv AT donaskonstantinosp periproceduraloutcomesofrotationalatherectomyassistedballoonangioplastyinisolatedatheroscleroticpoplitealarterylesionstheisopoptrial
AT psyllasanastasios periproceduraloutcomesofrotationalatherectomyassistedballoonangioplastyinisolatedatheroscleroticpoplitealarterylesionstheisopoptrial
AT pitouliasapostolosg periproceduraloutcomesofrotationalatherectomyassistedballoonangioplastyinisolatedatheroscleroticpoplitealarterylesionstheisopoptrial
AT kazemtashmajid periproceduraloutcomesofrotationalatherectomyassistedballoonangioplastyinisolatedatheroscleroticpoplitealarterylesionstheisopoptrial
AT dahifirouza periproceduraloutcomesofrotationalatherectomyassistedballoonangioplastyinisolatedatheroscleroticpoplitealarterylesionstheisopoptrial
AT abubakrnizar periproceduraloutcomesofrotationalatherectomyassistedballoonangioplastyinisolatedatheroscleroticpoplitealarterylesionstheisopoptrial
AT korosoglougrigorios periproceduraloutcomesofrotationalatherectomyassistedballoonangioplastyinisolatedatheroscleroticpoplitealarterylesionstheisopoptrial