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Open AccessArticle

Use of Rotational Atherectomy-Assisted Balloon Angioplasty in the Treatment of Isolated Below-the-Knee Atherosclerotic Lesions in Patients with Chronic Limb-Threatening Ischemia

by

Apostolos G. Pitoulias

^1,*

,

Gergana T. Taneva

²,

Konstantinos Avranas

²,

Nizar Abu Bakr

¹,

Georgios A. Pitoulias

² and

Konstantinos P. Donas

¹

¹

Rhein Main Vascular Center, Department of Vascular and Endovascular Surgery, Asklepios Clinics Langen, Paulinen Wiesbaden, Seligenstadt, 63225 Langen, Germany

²

Research Collaborator at Rhein Main Vascular Center, Department of Vascular and Endovascular Surgery, Asklepios Clinics Langen, Paulinen Wiesbaden, Seligenstadt, 63225 Langen, Germany

^*

Author to whom correspondence should be addressed.

J. Clin. Med. 2024, 13(5), 1346; https://doi.org/10.3390/jcm13051346

Submission received: 25 January 2024 / Revised: 10 February 2024 / Accepted: 19 February 2024 / Published: 27 February 2024

(This article belongs to the Section Vascular Medicine)

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Abstract

The aim of the study is to evaluate the safety and effectiveness of rotational atherectomy-assisted balloon angioplasty (BTK-RA) for the treatment of isolated below the knee (BTK) atherosclerotic lesions and to compare the outcomes to plain old balloon angioplasty (POBA). Between January 2020 and September 2023, 96 consecutive patients with chronic limb threatening ischemia (CTLI) and isolated BTK-lesions underwent POBA (group A) or BTK-RA (group B). The primary outcome measures were: periprocedural technical success, primary patency, postoperative increase of the ankle branchial index (ABI), target lesion revascularization (TLR), limb salvage, minor amputation and death. Both techniques had similar technical success, operative time, intraprocedural complications and bailout stent implantations, independently of the operator’s experience. Group B had significantly higher primary patency rates (93.5% vs. 72.0%, respectively, p = 0.006), TLR (2.1% vs. 24%, p = 0.057), lower in-hospital stay (2.0–3.0 vs. 4.0–6.0 days, respectively, p < 0.001) and higher postoperative ABI (0.8–0.2 vs. 0.7–0.1, respectively, p = 0.008), compared to group A. Significant differences (POBA n: 20, 40%, BTK-RA n = 3, 6.5%) were found in minor amputation rates between the two groups (p < 0.001), while the respective limb salvage rates were similar in both groups (94.0% vs. 97.8%, p = 0.35). The use of BTK-RA for the treatment of BTK-lesions in patients with CTLI showed significant clinical advantages in comparison to POBA.

Keywords: PAD; rotational atherectomy; BTK-lesions; CLI

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MDPI and ACS Style

Pitoulias, A.G.; Taneva, G.T.; Avranas, K.; Abu Bakr, N.; Pitoulias, G.A.; Donas, K.P. Use of Rotational Atherectomy-Assisted Balloon Angioplasty in the Treatment of Isolated Below-the-Knee Atherosclerotic Lesions in Patients with Chronic Limb-Threatening Ischemia. J. Clin. Med. 2024, 13, 1346. https://doi.org/10.3390/jcm13051346

AMA Style

Pitoulias AG, Taneva GT, Avranas K, Abu Bakr N, Pitoulias GA, Donas KP. Use of Rotational Atherectomy-Assisted Balloon Angioplasty in the Treatment of Isolated Below-the-Knee Atherosclerotic Lesions in Patients with Chronic Limb-Threatening Ischemia. Journal of Clinical Medicine. 2024; 13(5):1346. https://doi.org/10.3390/jcm13051346

Chicago/Turabian Style

Pitoulias, Apostolos G., Gergana T. Taneva, Konstantinos Avranas, Nizar Abu Bakr, Georgios A. Pitoulias, and Konstantinos P. Donas. 2024. "Use of Rotational Atherectomy-Assisted Balloon Angioplasty in the Treatment of Isolated Below-the-Knee Atherosclerotic Lesions in Patients with Chronic Limb-Threatening Ischemia" Journal of Clinical Medicine 13, no. 5: 1346. https://doi.org/10.3390/jcm13051346

APA Style

Pitoulias, A. G., Taneva, G. T., Avranas, K., Abu Bakr, N., Pitoulias, G. A., & Donas, K. P. (2024). Use of Rotational Atherectomy-Assisted Balloon Angioplasty in the Treatment of Isolated Below-the-Knee Atherosclerotic Lesions in Patients with Chronic Limb-Threatening Ischemia. Journal of Clinical Medicine, 13(5), 1346. https://doi.org/10.3390/jcm13051346

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