Refined Atherectomy. Built to Remove.
The Rotarex™ S Atherectomy System is designed to efficiently remove both plaque and thrombus by utilizing three distinct mechanisms of action to treat PAD lesions including in-stent restenosis. The device modifies, excises, and aspirates complex lesions with mixed plaque morphology with two different size options—6F & 8F.
We understand that anything that can help to save time and space, and reduce complexity in the lab is essential. The Rotarex™ S Atherectomy System is simple to set up and easy to use, with a small plug-and-play capital component and reusable handle that is easily draped. Additionally, the Rotarex™ S Atherectomy System does not require any warm up, infusion or catheter clean out.
STEP ONE:
Connect power cord
STEP TWO:
Connect motor to drive system
STEP THREE:
Drape motor and drive system
STEP FOUR:
Remove catheter from packaging and connect collecting bag
STEP FIVE:
Press catheter onto motor then flush
A meta-analysis of 8 clinical studies comprising data obtained from 2,107 patients studied from 2002 to 2015 was performed to:
| Measure/Outcomes | Mean (95% CI) |
| Age | 68.1 (66.4, 69.7) |
| Gender (% Male) | 65.3% (60.6%, 70.0%) |
| Rotarex™ Device Treatment Time (minutes) | 3.0 (1.3, 4.7) |
| Lesion Length (mm) | 153.96 (115.24, 192.69) |
| Technical Success | 95.8% (94.3%, 97.3%) |
| Clinical Success | 79.9% (75.2%, 84.5%) |
| TLR at 6 Months | 7.8% (1.0%, 14.5%) |
| TLR at 12 Months | 11.3% (7.4%, 15.3%) |
| Restenosis at 6 Months | 16.9% (0.0%, 35.3%) |
| Restenosis at 12 Months | 35.5% (19.6%, 51.4%) |
| Measure/Outcomes | Mean (95% CI) |
| ABI at 6 Baseline | 0.33 (0.18, 0.47) |
| ABI at 6 Months | 0.83 (0.78, 0.88) |
| ABI at 12 Months | 0.77 (0.71, 0.82) |
| Rutherford Score at Baseline | 3.54 (3.42. 3.67) |
| Rutherford Score at 6 Months | 1.51 (1.03, 2.00) |
| Rutherford Score at 12 Months | 2.13 (1.83, 2.42) |
| Procedure-Related Dissection | 5.9% (3.3%, 8.6%) |
| Procedure-Related Embolization | 7.5% (4.7%, 10.4%) |
| Procedure-Related Perforation | 2.2% (0.9%, 3.4%) |
| Procedure-Related Pseudo-Aneurysm | 1.5% (0.6%, 2.4%) |
| Procedure-Related Abrupt Reocclusion | 2.4% (1.0%, 3.7%) |
64-year-old male patient presented with left-sided CLI. Over the preceding four months the patient experienced left-sided rest pain and despite receiving best medical treatment, developed a dry, non-healing ulcer of the toe. Puncture of the right groin and cross-over approach, demonstrated a very long, 31 cm, TASC D, femoropopliteal CTO on angiogram. The SFA occlusion was recanalized with a wire intraluminally, followed by 3 passes of a 6F Rotarex S™ Atherectomy Catheter, after which 3 PTAs resulted in a completely restored flow. The patient remained asymptomatic after 18 months.
Before treatment, Flush occlusion of left SFA to PII segment. Crossed intraluminally with guidewire.
Extensive collaterals of SFA reconstituting at PII segment, with 2 vessel run-off BTK.
Angiogram after 1 and 3 passes with Rotarex™ Atherectomy Catheter.
Final angiogram showing restored flow in SFA and 3 vessel run-off BTK.
Dr. Aaron Frodsham, MD. Salt Lake City, UT, USA
Dr. Aaron Frodsham, MD. Salt Lake City, UT, USA
Dr. John Park, MD. Omaha, NE, USA
BD is proud to offer you this exclusive learning opportunity to further support your Peripheral Arterial Disease (PAD) education and training with the use of our Rotarex™ S Rotational Excisional Atherectomy System. We are committed to making your educational learning with BD Peripheral Intervention (BDPI) a success.
Faculty are available to answer questions about the Rotarex™ S Rotational Excisional Atherectomy System, such as: Case/Patient Selection, Device Set Up, Recommendations for Device Use, or Discuss Your Experience With An Expert.
1. Rotarex™ S Atherectomy System eIFU
2. All case images are courtesy of the various clinicians
NEWS
Leipzig’s Experience Using Rotarex™ Rotational Excisional Atherectomy for In-Stent Reocclusion in Peripheral Arterial Occlusive Disease
PRESS RELEASE
BD Announces 510(k) Clearance of Expanded Indications for the Rotarex™ Atherectomy System
NEWS
Rotational Excisional Atherectomy With the Rotarex™ Atherectomy Device – Miguel Montero-Baker, MD
AMP 2020
Refining Atherectomy in Challenging Lesions with Mixed Plaque Morphology
AMP 2020
Atherectomy with Thrombectomy: The Rotarex Rotational Excisional Atherectomy System
Please consult product labels and inserts for indications, contraindications, hazards, warnings, precautions and directions for use.
BD-27143v5
The Rotarex™ S Atherectomy System is intended for use as an atherectomy device and to break up and remove thrombus from native peripheral arteries or peripheral arteries fitted with stents, stent-grafts or native or artificial bypasses.
In patients not suitable for atherectomy/thrombectomy • In the cardiopulmonary, coronary, carotid, cerebral and renal vasculature • In vessels that are undersized for the device used • In the venous vasculature
Do not use in anatomical locations with persistent vasospasm • The Rotarex™ family of catheters may only be used with the BD supplied guidewire with which they are packaged • The catheter must always be guided via the supplied guidewire, which has been correctly positioned according to the instructions for use. Do not use the catheter without the supplied guidewire or over the supplied guidewire which is incorrectly placed • If the supplied guidewire is in a subintimal position of any length, reposition and ensure it is intraluminal before proceeding • Do not use the catheter if the supplied guidewire has become threaded or entangled in the wire mesh of a stent, stent-graft or the lining of a stent-graft •Position the flexible tip of the supplied guidewire as far distally as possible from the vessel occlusion being treated to avoid the tip being aspirated into the rotating helix. The recommended distance is at least 10 cm. Operators should take care that manipulations of the catheter do not alter the desired position of the supplied guidewire • Do not use inside or via narrow vessel radii or in tortuous vessel courses(bending radius of catheter shaft < 2 cm) • Do not use in calcified vessel segments with presence of radiopacities on both sides of the arterial wall and extending more than 1 cm of length prior to contrast injection or digital subtraction angiography • Do not use this device at or near locations with preexisting damage to the vessel wall from prior surgery, aneurysms, or other disease • Remove catheter and supplied guidewire from patient before employing magnetic resonance imaging (MRI) or using a defibrillator • Do not use Rotarex™ Atherectomy Catheters when product damage is evident, whose packaging is damaged, or where the sterilization expiration date has passed • This device is intended for use only by suitably qualified medical personnel experienced in the diagnosis and treatment of peripheral vascular disease by percutaneous methods • This device may only be used in conjunction with the Drive System • This device is supplied sterile for single-use only. Do not reprocess or resterilize. Resterilization or reconditioning may severely impair the function of the device • Risk of distal embolization is greatly increased if the operator attempts to advance the catheter faster than the recommendations in these instructions, especially near the distal end of the occlusion • Failure to ensure sufficient blood flow to the catheter head could result in vessel collapse • Monitor the blood flow to the collecting bag continuously throughout the procedure • Do not operate near fractured areas of broken stents or stent-grafts. If a protruding stent strut penetrates into the side window of the catheter head, the stent, stent-graft, or vessel may become severely damaged, destroyed and/or dislodged, or the catheter head may become entrapped in the stent or stent-graft in such a manner that the catheter and the stent or stent-graft must be surgically recovered • This device should only be used under adequate visual monitoring with suitable radiographic techniques
This device does not contain any parts that can be maintained or serviced by the end-user. Do not repair or change the configuration of the device • Use of the device through a kinked or damaged introducer or where the catheter itself has become kinked or bent, may cause erratic function and/or device failure• Catheters must not be allowed to operate “dry” and must be primed and flushed using heparinized saline before and during use per the instructions in this IFU. Throughout catheter use, always ensure there is a sufficient blood flow to the catheter head. Allowing the catheter to operate without heparinized saline solution priming and flushing or without adequate amounts of aspirated blood, will cause the device to operate erratically and/or cease functioning • Failure to manipulate the catheter slowly in a back and forth motion as described in these instructions may result in fracture of the helix and/or supplied guidewire • Insufficient blood flow through the catheter may result in intra-catheterclotting, slow or absent therapeutic function, fracture of the helix and/or supplied guidewire, and/or overheating of the catheter • The guidewire adaptor must be in the working position (pulled back) when the motor is active • When active, the handle of the Rotarex™ Catheter and the portion of the catheteroutside the patient’s body must be kept at the same height as the introducer sheath and straight at all times with the outlet tube to the collecting bag hanging vertically below the motor in a straight line. Failure to position the catheter and outlet tube in this manner may result in catheter blockage, helix fracture and/or supplied guidewire fracture • If the supplied guidewire begins to rotate with the helix, which may occur if the helix and supplied guidewire become bonded with fibrin, the procedure must be immediately stopped; the catheter thoroughly flushed and the supplied guidewire changed
Potential adverse events include, but are not limited to: • Embolization, especially distal embolization •Pulmonary embolisms of all degrees of severity • Thrombosis • Re-occlusion • Vessel wall injury • Vesseldissection / perforation/rupture • Perforation as a result of mural calcium being torn out of the vessel wall • Arteriovenous fistula / pseudo-aneurysm • Hematoma, bleeding, hemorrhage • Organ perforation• Implants such as stents/stent grafts / bypass grafts getting damaged, caught or dislodged •Disruption of the catheter: debris remaining in the body • Allergic reactions, including allergic reactions to device components • Infections or necrosis at the puncture site • Catheter-induced sepsis • Death
