Post on 22-Oct-2020
Rotational thombectomy (Rotarex©) for(sub)acute limb ischemia – a safe approach
also in patients with diabetes mellitus?
M. Dufner, M. Kronlage, I. Printz, B. Heilmeier, E. Blessing, O. Müller, H. Katus, C. Erbel
Matthias Dufner
University Hospital Heidelberg, Germany
Disclosure
Speaker name:
Matthias Dufner
I have the following potential conflicts of interest to report:
Consulting
Employment in industry
Stockholder of a healthcare company
Owner of a healthcare company
x Other(s): Educational Grant / Abbott
I do not have any potential conflict of interest
Objective
Compare the safety and efficacy of rotationalthrombectomy (Rotarex©) in patients with and
without diabetes mellitus.
source: straubmedical.com
Design
• Retrospective
• 2006-2015
• Single-center
• Dept. of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Germany
• Non-randomized
Study population
No Diabetes mellitus Diabetes mellitus p-value
absolut SD % absolut SD %
146 98 67,1 48 32,9
Characteristics
Age (years) 66,9 11,7 68,5 10,7 0,3148
Gender male 60 61,2 33 68,80,3744
female 38 38,8 15 31,2
Weight 70,9 14 80,7 12,3 0,0003
Comorbidities
Smoker 69 70,4 29 60,4 0,2273
Ischemic heart disease 35 35,7 31 64,6 0,0010
Arterial hypertension 70 71,4 43 89,6 0,0137
Kidney failure III-V 22 22,5 14 29,2 0,3763
Rutherford class
No Diabetes mellitus Diabetes mellitus p-value
absolut % absolut %
146 98 67,1 48 32,9
Rutherford class 3 68 69,4 27 56,0
0,1212
4 22 22,2 10 20,8
5 3 3,1 5 10,4
6 2 2,0 4 8,3
n.a. 3 3,0 2 4,2
No DM DM0
20
40
60
80
100
3
4
5
6
n.a.
Perc
en
tag
e (
%)
n.a.: information not available
Lesion characteristics
No Diabetes mellitus Diabetes mellitus p-value
absolut % absolut %
146 98 67,1 48 32,9
Major lesion
Native vessel 67 76,1 33 68,8 0,3508
Bypass 2 2,0 0 0,0 0,3190
Target lesion(s)
Iliac vessels 16 16,3 4 8,3 0,1870
Superficial femoral artery 76 77,6 44 91,7 0,0362
Below the knee 23 23,5 11 22,9 0,9408
Lesion characteristics
Length of occlusion (cm) >10 26 26,5 9 18,8 0,3009
Results
1) Primary revascularization success
No DM DM0
20
40
60
80
100
Perc
en
tag
e (
%)
ns
p = 0,7338
Results
2) Periprocedural complications
No Diabetes mellitus Diabetes mellitus p-value
absolut % absolut %
146 98 67,1 48 32,9
Major bleeding 3 3,1 2 4,2 0,7301
Aneurysma sp. 3 3,1 1 2,1 0,7338
AV-fistula 1 1,0 0 0,0 0,4825
Compartment syndrome 0 0,0 0 0,0
Results
3) 1 year patency
0 100 200 300 3650
20
40
60
80
100
Days elapsed
Perc
en
tag
e (
%)
No DM
DM
p = 0,1601
Results
4) Survival
0 100 200 300 3650
20
40
60
80
100
Days elapsed
Perc
en
tag
e (
%)
Survival
No DM
DM
p = 0,0787
0 100 200 300 3650
20
40
60
80
100
Days elapsed
Perc
en
tag
e (
%)
Event free survival
No DM
DM
p = 0,1007
Limitations
• Group size
• Retrospective
• Loss to follow up
Conclusion
For (sub)acute limb ischemia, rotationalthrombectomy (Rotarex©) is a safe and effectivetechnique in patients with and without diabetes
mellitus.
Thank you!
... and hope to see you soon in Heidelberg!
Further characteristics
No Diabetes mellitus Diabetes mellitus p-value
absolut % absolut %
146 98 67,1 48 32,9
Acute ischemia 6 6,1 4 8,3 0,6193
Critical ischemia 7 7,1 5 10,4 0,4987
Stent 56 57,1 25 52,1 0,5634
DCB 47 48,0 27 56,3 0,3466
Loss to follow up (1 year) 25 22,5 10 20,8 0,5341
Lesion characteristics
No Diabetes mellitus Diabetes mellitus p-value
absolut % absolut %
146 98 67,1 48 32,9
Major lesion
Native vessel 67 76,1 33 68,8 0,3508
Bypass 2 2,0 0 0,0 0,3190
Target lesion(s)
Iliacal vessels 16 16,3 4 8,3 0,1870
Superficial femoral artery 76 77,6 44 91,7 0,0362
Below the knee 23 23,5 11 22,9 0,9408
Lesion characteristics
Thrombotic burden low 33 33,7 17 35,4 0,8348
moderate-severe 65 66,3 31 64,6
Length of occlusion (cm) >10 26 26,5 9 18,8 0,3009
Lesion characteristicsNo Diabetes mellitus Diabetes mellitus p-value
absolut % absolut %
146 98 67,1 48 32,9
Rutherford 3 68 69,4 27 56,0
0,1212
4 22 22,2 10 20,8
5 3 3,1 5 10,4
6 2 2,0 4 8,3
n.a. 3 3,0 2 4,2
Major lesion
Native vessel 67 76,1 33 68,8 0,3508
Bypass 2 2,0 0 0,0 0,3190
Target lesion(s)
Iliacal 16 16,3 4 8,3 0,1870
Superficial femoral artery 76 77,6 44 91,7 0,0362
Below the knee 23 23,5 11 22,9 0,9408
Lesion characteristics
Length of occlusion (cm) >10 26 26,5 9 18,80,3009
Rotational thombectomy (Rotarex©) for(sub)acute limb ischemia – a safe approach
also in patients with diabetes mellitus?
M. Dufner, M. Kronlage, I. Printz, B. Heilmeier, E. Blessing, O. Müller, H. Katus, C. Erbel
Matthias Dufner
University Hospital Heidelberg, Germany