Rotation angioplasty--clinical experiences in 83 patients with chronic arterial vascular occlusion

• Published in: Herz Vol. 14; no. 1; p. 39
• Main Authors: Vallbracht, C, Prignitz, I, Liermann, D, Roth, F J, Kollath, J, Beinborn, W, Stickelmann, G, Landgraf, H, Schoop, W, Kaltenbach, M
• Format: Journal Article
• Language: German
• Published: Germany 01.02.1989
• Subjects: Aged; Angiography; Angioplasty, Balloon - instrumentation; Arterial Occlusive Diseases - diagnostic imaging; Arterial Occlusive Diseases - therapy; Female; Humans; Ischemia - therapy; Leg - blood supply; Male
• ISSN: 0340-9937

Chronic, total vascular occlusion represents the limit for use of balloon dilatation. Occlusions of the superficial femoral artery and popliteal artery of more than 10 cm in length have a low recanalization rate of 50 to 60% with conventional angioplasty. In iliac artery occlusions, in addition to a high rate of complications, the recanalization rate is only about 30 to 40%. Starting in 1984, we developed a slowly rotating (100 to 200 r.p.m.), electrically-driven, flexible catheter with a blunt tip, inside lumen and outer diameter of 2.2 mm for the purpose of recanalization (Figure 1). The theoretical basis was that such a catheter would seek the soft occluding thrombus as the path of least resistance. Since 1986, the procedure has been carried out in 56 patients with occlusion of the superficial femoral artery, 21 with occlusion of the popliteal artery and six with occlusion of the iliac artery. The duration of occlusion ranged between five and 48 months and the length of the occlusions between 5 and 35 cm (mean 12.5 cm); the patients were in Fontaine stage II and IV, the ankle arm-index ranged between 0 and 0.86 (mean 0,51). After antegrade or retrograde puncture of the common femoral artery and intra-arterial injection of 5,000 units of heparin, the rotation catheter was advanced through an 8F sheath through the occlusion by means of slow rotation (Figure 2). After contrast medium injection to document the intraluminal position of the catheter and the catheter exchange over a 0.35'' wire, the channel created was dilated.