Jetstream^® atherectomy for subacutely or chronically occluded femoro‐popliteal prosthetic bypass grafts

Abstract

A failed infrainguinal bypass is associated with poor prognosis for the limb in question, particularly if the graft was initially placed for limb salvage. Revascularization of occluded grafts is an important but challenging issue. We present three patients with occluded femoro-popliteal graft in whom the Jetstream(®) system was used successfully to perform thromboatherectomy. The Jetstream(®) system is minimally invasive and avoids use of thrombolytic therapy and its associated costs and complications. The device seems to be highly effective in removing thrombus beyond the acute setting.

Jetstream XC Device for Treatment of Long Viabahn Stents Occlusions in the Superficial Femoral Artery: A Report of Two Cases

“…When a device encounters high resistance, device stall and wire entrapment would happen and can disrupt the atherectomy procedure. 10 ) However, our patients had a relatively straight course of the targeted vessel, we did not have any device-graft interaction. The etiologies for these recurrent presentations were likely multifactorial such as repetitive elongation between the foreign body and native vessel plus intimal hyperplasia.…”

Acute on chronic limb ischemia: From surgical embolectomy and thrombolysis to endovascular options

“…Evidence of its efficacy is well described in literature in case of chronic vessel occlusion or in-stent restenosis 54,55 , while it remains still under-investigated in case of acute limb ischemia. 56 Still, abrupt vessel occlusion, dissection, distal emboli, hematoma at access site, infection, perforation, pseudoaneurysm, renal failure, restenosis, and thrombus formation are some of the reported complications of Jetstream atherectomy. 57…”

Commentary: Treating Subacute Thrombus in Peripheral Arterial Disease

“…Another strategy in treating subacute thrombus is mechanical, with laser ablation or cutting/aspiration using newer rotational atherectomy devices [JetStream (Boston Scientific, Natick, MA, USA) or Rotarex (Straub Medical AG, Wangs Switzerland)]. 9,10 This is likely to be partially effective, but additional treatments are generally required. Also, the impact of significant residual thrombus on procedure success, recurrent occlusions, and long-term results is unknown.…”