Introduction: Balloon angioplasty in the femoropopliteal segment carries high success rates, especially for the
short lesions, the primary patency after 1 year reaches a low rate of 47% to 65%. Selective stenting was done if
there is flow-limiting dissection, or residual stenotic, were the primary patency increases to about 65 % at three
years. The technique of Atherectomy depends on using a rotating cutting blade at its tip to excise the atheroma.
Pathients and methods: A total of 52 patients with CLI due to occlusions in the femoropopliteal segment. The
patients were enrolled in a prospective non- randomized controlled study from February 2023 to March 2024. The
first group was managed by Rotarex® device augmented by PTA if needed; the second group was managed by
plain balloon angioplasty with selective stenting. Primary outcomes were safety, rate of stent application in each
group and Secondary outcomes were technical success, clinical success, patency rates, limb salvage, rate of major
adverse events.
Results: Primary assisted patency after six months was 80.77 % in Rotarex® group compared to 69.23 %
in PTA group. Total number of major amputations were one case (3.85%) in Rotarex® group versus 5 cases
(19.23%) in PTA group and the mortality at six months were 3 cases versus 2 cases in the Rotarex® group and
PTA respectively.
Conclusion: Recanalization of chronically occluded femoropopliteal segment using Rotarex® system- is an
advisable technique, with clinical and technical success better than traditional plain angioplasty with a lower rate
of stenting.