Jetstream Atherectomy System for Treatment of Femoropopliteal Artery Disease: A Single Center Experience and Mid-term Outcomes.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 01 03 2019
revised: 03 04 2019
accepted: 06 04 2019
pubmed: 29 9 2019
medline: 14 4 2020
entrez: 28 9 2019
Statut: ppublish

Résumé

The aim of this study is to assess our experience and mid-term outcomes using Jetstream atherectomy system for treatment of femoropopliteal artery disease (FPAD). Data of 30 patients with FPAD treated at our center between 2013 and 2016 were analyzed. Two subgroups of patients were identified: Group A included patients (n = 18) with de novo lesions; Group B (n = 12) included those with in-stent restenosis. The primary study end points assessed were technical success, perioperative mortality, and major adverse event (MAE) rate at 30 days (distal embolization, major amputation, and target lesion revascularization). Other outcomes measured were survival, primary, and secondary patency, and freedom from amputation at 1 and 3 years of follow-up, respectively. Technical success was 100% for both groups. The MAE rate was 8.7%. No distal filter was adopted during intervention. Angioplasty was associated with 93.3% of cases (93.3% vs. 100%; P = 0.15), drug-eluting balloon (DEB) in 12 cases (22.2% vs. 66.6%; P = 0.008), drug-eluting stent and bare metal implantation in 1 (5.6% vs. 0%; P = 1) and 4 cases (11.1% vs. 16.7%; P = 1), respectively. The cumulative primary and secondary patency rates were 75.1% and 95.5% at 1 year, and 70.4% and 84.8% at 3 years of follow-up, respectively. The survival and freedom from amputation were 96.4% and 85.8% at 1 and 3 years of follow-up, respectively. The freedom from target lesion revascularization was 91.7% and 83.4% at 1 and 3 years from intervention. The use of the Jetstream appears to be safe and feasible with no distal embolization and low rate perioperative complications. Moreover, encouraging outcomes were observed when atherectomy was associated to DEB angioplasty.

Sections du résumé

BACKGROUND BACKGROUND
The aim of this study is to assess our experience and mid-term outcomes using Jetstream atherectomy system for treatment of femoropopliteal artery disease (FPAD).
METHODS METHODS
Data of 30 patients with FPAD treated at our center between 2013 and 2016 were analyzed. Two subgroups of patients were identified: Group A included patients (n = 18) with de novo lesions; Group B (n = 12) included those with in-stent restenosis. The primary study end points assessed were technical success, perioperative mortality, and major adverse event (MAE) rate at 30 days (distal embolization, major amputation, and target lesion revascularization). Other outcomes measured were survival, primary, and secondary patency, and freedom from amputation at 1 and 3 years of follow-up, respectively.
RESULTS RESULTS
Technical success was 100% for both groups. The MAE rate was 8.7%. No distal filter was adopted during intervention. Angioplasty was associated with 93.3% of cases (93.3% vs. 100%; P = 0.15), drug-eluting balloon (DEB) in 12 cases (22.2% vs. 66.6%; P = 0.008), drug-eluting stent and bare metal implantation in 1 (5.6% vs. 0%; P = 1) and 4 cases (11.1% vs. 16.7%; P = 1), respectively. The cumulative primary and secondary patency rates were 75.1% and 95.5% at 1 year, and 70.4% and 84.8% at 3 years of follow-up, respectively. The survival and freedom from amputation were 96.4% and 85.8% at 1 and 3 years of follow-up, respectively. The freedom from target lesion revascularization was 91.7% and 83.4% at 1 and 3 years from intervention.
CONCLUSIONS CONCLUSIONS
The use of the Jetstream appears to be safe and feasible with no distal embolization and low rate perioperative complications. Moreover, encouraging outcomes were observed when atherectomy was associated to DEB angioplasty.

Identifiants

pubmed: 31560939
pii: S0890-5096(19)30742-3
doi: 10.1016/j.avsg.2019.04.052
pii:
doi:

Substances chimiques

Coated Materials, Biocompatible 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

365-374

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Vincenzo Ardita (V)

Vascular Surgery Unit, Cardiovascular Thoracic Department, Hospital S. Raffaele, Vita-Salute University, Milan, Italy. Electronic address: ardita.vincenzo@hsr.it.

Sonia Ronchey (S)

Unit of Vascular Surgery, Cardiovascular Thoracic Department, Hospital S. Filippo Neri, Rome, Italy.

Matteo Orrico (M)

Unit of Vascular Surgery, Cardiovascular Thoracic Department, Hospital S. Filippo Neri, Rome, Italy.

Vincenzo Pappalardo (V)

Department of Surgery, Circolo Hospital and Macchi Foundation, Varese, Italy.

Alberto Davì (A)

Unit of Vascular Surgery, Cardiovascular Thoracic Department, Hospital S. Filippo Neri, Rome, Italy.

Stefano Fazzini (S)

Unit of Vascular Surgery, Cardiovascular Thoracic Department, Hospital S. Filippo Neri, Rome, Italy.

Vittorio Alberti (V)

Unit of Vascular Surgery, Cardiovascular Thoracic Department, Hospital S. Filippo Neri, Rome, Italy.

Nicola Mangialardi (N)

Unit of Vascular Surgery, Cardiovascular Thoracic Department, Hospital S. Filippo Neri, Rome, Italy.

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