Post on 16-Oct-2021
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 1 Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved.
BTK Case Studies Joseph Cardenas, MD
AZ Heart & Vascular, Yuma, AZ
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 2
Case 1
78 yr. old female
Rutherford Class II/III lesion
1 block claudicant
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 3
Pre Treatment Post Treatment
Anterior Tibial Artery Occlusion 1.75mm Peripheral RotaLink™ Plus
Catheter, followed by 2.5x150mm PTA
MOVIE MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 4
Pre
-Rota
Post-
Rota
1.75mm Rota Burr at Proximal cap 1.75mm Rota Burr through
occlusion 2.5x150mm Post-PTA
160,000 RPM 1 min 48 sec total burr time 6 ATM for 1 min
MOVIE MOVIE MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 5
Case 2
81 yr. old male
Failed medical management
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 6
Pre Treatment Post Treatment
Distal Popliteal Stenosis 2.00mm Peripheral RotaLink™ Plus Catheter,
followed by 3x40mm PTA
MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 7
Pre
-Rota
Post-
Rota
2.00mm Rota Burr through Distal
Popliteal Stand-Alone result 3x40mm Post-PTA
160,000 RPM 58 sec total burr time 8 ATM for 1 min
MOVIE MOVIE MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 8
Case 3
64 yr. old male
2 block claudication
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 9
Pre Treatment Post Treatment
Anterior Tibial Artery CTO 1.75mm Peripheral RotaLink™ Plus Catheter,
followed by 2.5/3.0x220mm tapered PTA
MOVIE MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 10
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 12
Pre
-Rota
Post-
Rota
1.75mm Rota Burr through ATA Stand-Alone result 2.5/3.0x220mm tapered Post-
PTA
160,000 RPM 2 min 45 sec total burr time 6 ATM for 1 min
MOVIE MOVIE MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 13
Case 4
72 yr. old male
Failed medical management
Single vessel run-off
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 14
Pre Treatment Post Treatment
Ostial Anterior Tibial Artery Stenosis 1.75mm Peripheral RotaLink™ Plus Catheter,
stand-alone
MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 15
Pre
-Rota
Post-
Rota
1.75mm Rota Burr through ATA Stand-Alone result
160,000 RPM 56 sec total burr time
MOVIE MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 16
Case 5
80 yr. old male
Non-healing toe, hallux
Antegrade stick
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 17
Pre Treatment Post Treatment
Dorsalis Pedis Stenosis 1.50mm Peripheral RotaLink™ Plus Catheter,
followed by 2x20mm PTA
MOVIE MOVIE
Copyright © 2014 by Boston Scientific Corporation or its affiliates. All rights reserved. PI-239309-AA Apr 2014 18
RotablatorTM Rotational Atherectomy System
Brief Summary Prior to use, please see the complete “Directions for Use” for more information on Indications, Contraindications, Warnings, Precautions, Adverse Events
and Operator’s Instructions.
CAUTION: Federal (U.S.) Law restricts this device to sale by or on the order of a physician.
INTENDED USE/INDICATIONS FOR USE: The Rotablator Rotational Atherectomy System is intended for percutaneous use in the peripheral vessels in
patients with occlusive atherosclerotic disease who are acceptable candidates for endovascular procedures.
CONTRAINDICATIONS: Occlusions through which a guidewire will not pass. Use in coronary arteries. Long (≥ 20 cm) total occlusions. Angiographic
evidence of thrombus prior to treatment with the Rotablator Rotational Atherectomy System. Such patients may be treated with thrombolytics
(e.g.,Urokinase). When the thrombus has been resolved for two to four weeks, the lesion may be treated with the Rotablator Rotational Atherectomy
System. Angiographic evidence of significant dissection at the treatment site. The patient may be treated conservatively for approximately four weeks to
permit the dissection to heal before treating the lesion with the Rotablator Rotational Atherectomy System.
RESTRICTIONS: Federal (USA) law restricts the use of this system to physicians who are credentialed in peripheral angioplasty and who have attended
the Rotablator System Physician Training Program.
PRECAUTIONS: Percutaneous rotational angioplasty with the Rotablator Rotational Atherectomy System should only be carried out at hospitals where
emergency bypass surgery can be immediately performed in the event of a potentially injurious or life-threatening complication. Appropriate drug therapy
including (but not limited to) anticoagulant and vasodilator therapy must be provided to the patient during all phases of patient care. When the Peripheral
RotaWire™ Guidewires and/or Peripheral RotaLink™ Plus Catheters are in the body, they should only be manipulated while they are under fluoroscopic
observation with radiographic equipment that provides high resolution images. Use only normal saline as the infusate. Never inject contrast agent, or any
other substance that is not approved as part of the Rotablator Rotational Atherectomy System, into the infusion port or saline infusion bag as this may
cause permanent damage to the Peripheral RotaLink Plus Catheter.
ADVERSE EVENTS: Potential adverse reactions which may result from the use of this device include but are not limited to: Additional intervention,
Allergic reaction, Amputation, Death, Embolism, Hematoma/Hemorrhage, Hemodynamic changes, Hemoglobinuria, Infection, Restenosis, Stroke, Slow, no
flow, abrupt vessel closure, Surgery including arterial bypass, Thrombosis and vessel occlusion, Vessel trauma (dissection, perforation, psudoaneurysm,
arteriovenous fistula). There may also be complications associated with distortion, kinks, and fracture of the guidewire and physical deterioration or
malfunction of the device, which can lead to patient injury or death.
WARNINGS: The risks of Rotational Atherectomy can be reduced if the device and associated accessories are used in the appropriate patient population
by a physician who has had adequate training. The use of Rotablator for in-stent restenosis might lead to damage of stent components and/or Rotablator
System, which may lead to patient injury.
Rotablator, RotaLink, and RotaWire are registered or unregistered trademarks of Boston Scientific Corporation or its affiliates. All other trademarks are property of their
respective owners.
Results from case studies are not predictive of results in other cases. Results in other cases may vary. Case images and videos provided by Dr. Joseph Cardenas.