Jetstream Atherectomy System treatment of femoropopliteal arteries: Results of the post-market JET Registry

Gray, William A.; Garcia, Lawrence A.; Amin, Ali Hama; Shammas, Nicolas W.; Investigators, Jet Registry

doi:10.1016/j.carrev.2017.12.015

Cited by 37 publications

(18 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Trials such as the postmarket JET Registry enrolled only patients in Rutherford class 1 to class 3, whereas more than half of the patients in this cohort presented with preprocedure rest pain or tissue loss. The adjunctive stent rate in previous studies is as high as 35%, 7 but similar outcomes were achieved without any stent placement after rotational atherectomy in this cohort. Last, mean lesion length is >13 cm in this group and far exceeds the complexity of lesions studied in the Pathway PVD trial.…”

Section: Discussionsupporting

confidence: 80%

“…This study was followed by the release of the 2018 postmarket JET Registry studying the Jetstream (Boston Scientific, Marlborough, Mass) atherectomy device. 7 All lesions were confined to the femoropopliteal arteries, and 241 patients were enrolled with a mean age of 67 years, 41% diabetes rate, and Rutherford class 1 to class 3. All de novo or restenotic femoropopliteal lesions $4 cm were included, and mean lesion length was 16.4 6 13.6 cm with a 35% adjunctive stent rate.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of rotational atherectomy in complex lesions of the superficial femoral artery

Ponukumati

Suckow

Powell

et al. 2021

Journal of Vascular Surgery

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

Outcomes of rotational atherectomy in complex lesions of the superficial femoral artery

Ponukumati

Suckow

Powell

et al. 2021

Journal of Vascular Surgery

View full text Add to dashboard Cite

“…Table 1 lists real-world registries and single-center studies that have examined different endovascular treatments for complex femoropopliteal disease. 4,7–20 Clearly, the IN.PACT Global clinical cohort has complex disease presentations comparable to these other real-world studies. Unfortunately, we do not see homogeneity in the nomenclature for complex real-world femoropopliteal lesions across the different databases and registries.…”

Section: Putting the Study To The Testmentioning

confidence: 58%

Commentary: Leave Nothing Behind: No Stent, No Restenosis, No Mortality

2020

View full text Add to dashboard Cite

It is well-known and often argued by practicing physicians that the highly selected patients in the randomized controlled trials (RCTs) of lower extremity arterial disease do not often match the patients encountered in real-world practice. 1 Therefore, it is imperative to review and understand real-world studies to see if the proof of concept is carried on from the RCTs to the ground reality. Drug-coated balloon (DCB) angioplasty for femoropopliteal arterial disease can be considered a landmark endovascular treatment strategy in the field of symptomatic lower extremity occlusive disease. 1,2 In the October 2020 issue of the JEVT, Torsello et al 4 present the 3-year outcomes of the IN.PACT Global study of DCB angioplasty in a real-world femoropopliteal cohort. To put these results into perspective, we need to thread back into history. The IN.PACT Global study 2 (ClinicalTrials.gov identifier NCT01609296) was designed to see how DCB angioplasty fared in real-world, complex femoropopliteal disease, including long lesions (≥15 cm), in-stent restenoses (ISR), chronic total occlusions (CTOs) ≥5 cm long, calcified lesions, and TransAtlantic Inter-Society Consensus (TASC) C/D lesions, as well as in the setting of poor runoff, popliteal artery involvement, and bilateral disease. The clinical presentation in the 1535 participants was consistent with claudication and chronic limb-threatening ischemia (CLTI). The first publication from the IN.PACT Global study, 5 in a 131-patient ISR subgroup (mean lesion length 17.17 cm, 34% CTOs, 59.1% with calcifications, 88% with diffuse ISR, and 42% with TASC C/D lesions), 5 found a 1-year clinically-driven target lesion revascularization (CD-TLR) rate of 7.3%, with estimated primary patency of 88.7%. The primary safety outcomes were achieved in 92.7%. The 2-year outcomes reported by Micari et al 6 on 1406 patients (1773 lesions) in the clinical cohort study were promising, with estimated freedom from CD-TLR as high as 83.3% and meeting the composite safety endpoint in 81.7%. It is reassuring to know that these positive results were sustained through 36 months, 4 with estimated freedom from CD-TLR at 76.9% and a composite safety endpoint of 75.6%. Notably, the death rate climbed from 7.0% at 24 months to 11.6% at 36 months.

show abstract

“…In another study on the safety and efficacy of the Jetstream device in a real-world setting in 241 patients with femoropopliteal disease, the Jetstream achieved a high procedural success of 98.3% with low procedural complication rates (1% distal embolisation), and a relatively high rate of freedom from target lesion revascularisation (82%) after 1 year. 25 However, higher rates of distal embolisation (8%) were reported in another similar study, which could be reduced to 2% using a distal protection filter. 26 Figure 3 shows a chronic long occlusive lesion beginning at the level of the proximal SFA with scarce filling of the distal SFA.…”

Section: Rotational Atherectomymentioning

confidence: 82%

The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives

Korosoglou¹,

Giuşcă²,

Andrassy³

et al. 2019

Vascular and Endovascular Review

View full text Add to dashboard Cite

The prevalence of peripheral artery disease (PAD) has been rising consistently over the past few decades, along with increasing rates of type 2 diabetes. More than 200 million people are estimated to be affected by PAD worldwide. 1 Despite aggressive modifications of lifestyle and risk factors, and advances in the pharmacological management of patients with PAD using antiplatelet agents, statins, cilostazol, angiotensin-converting enzyme inhibitors, angiotensinreceptor blockers and low-dose anticoagulation with rivaroxaban, patients with PAD frequently require invasive procedures to improve the symptoms of claudication and prevent tissue damage or loss in those with critical limb ischaemia (CLI). 2 Due to recent technological advances in materials and devices for the endovascular treatment of PAD, a minimally invasive percutaneous approach is considered a first-choice strategy for the treatment of symptomatic patients and is given preference over older surgical options. According to current guidelines, endovascular therapy is the most favoured option for infrainguinal stenotic or occlusive lesions <25 cm, whereas open surgery may be associated with better longterm patency, especially when using saphenous vein grafts in patients with long occlusive lesions (>25 cm) that cross the knee. 3 Commonly used techniques include plain balloon angioplasty, drug-coated balloon (DCB) angioplasty, bare metal stents, drug-eluting stents and stent grafts for vessel perforation. Such endovascular approaches have been successfully used to alleviate symptoms in patients with claudication and have been associated with limb salvage in patients with CLI. [4][5][6] In many cases, such 'basic' approaches may be compromised by severe calcification. Calcification may be the reason for a poor primary outcome due to early recoil or extensive flow-limiting dissections after high-pressure angioplasty, culminating in the need for bailout stent placement. 7 Despite the most recent self-expandable nitinol stent technology, rates of re-stenosis may be high, resulting in primary patency rates of <50% for bare metal stents and <70% for drug-eluting stents at 5-year follow-up. 8 Even with dedicated stent devices, stent fractures may occur at sites of extensive movement and flexion as in the popliteal artery, resulting in stent thrombosis and subsequent occlusion. 9 With conventional open surgery, 5-year patency rates of more than 80% have been reported with saphenous vein grafts compared with 67% when using prosthetic conduits. 10 Although no randomised trials are currently available for a head-to-head comparison of endovascular versus surgical treatment for long and calcified femoropopliteal lesions, AbstractAn ageing population and the increasing prevalence of cardiovascular risk factors have aggravated the burden of peripheral artery disease (PAD). Despite advances in the pharmacological treatment of atherosclerosis, many patients with symptomatic PAD require invasive procedures to reduce the symptoms of claudication, salvage tissue and prevent a...

show abstract

Jetstream Atherectomy System treatment of femoropopliteal arteries: Results of the post-market JET Registry

Cited by 37 publications

References 25 publications

Outcomes of rotational atherectomy in complex lesions of the superficial femoral artery

Outcomes of rotational atherectomy in complex lesions of the superficial femoral artery

Commentary: Leave Nothing Behind: No Stent, No Restenosis, No Mortality

The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives

Contact Info

Product

Resources

About