{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T21:33:28Z","timestamp":1786743208918,"version":"build-2736575974"},"reference-count":58,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100017412","name":"BD","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017412","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Rotational percutaneous mechanical thrombectomy with adjunctive angioplasty, stenting or limited thrombolysis (rPMT+) has become commonplace in the treatment of acute and subacute limb ischaemia (SLI). This systematic review and proportional meta-analysis synthesises the available evidence on its safety and efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>MEDLINE, Embase and the Cochrane Library.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods:<\/jats:title>\n                    <jats:p>We searched for studies (\u226510 patients) published since January 1, 2012 (PROSPERO protocol CRD420251015846). Risk of bias was assessed using RoBANS 2. Proportional meta-analysis maximised representative sample sizes by incorporating both single-arm and comparative studies. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) evidence profiles were developed for each outcome of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty-four studies \u2013 7 comparative and 17 single arm \u2013 containing 2954 procedures (2697 rPMT+, 257 controls) met eligibility criteria. There were no randomised controlled trials. The pooled technical success (TS) rate for rPMT+ was 98% (95% confidence interval [CI]: 97%\u2013100%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001). Amputation-free survival (AFS) was 96% (95% CI: 93%\u201398%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001). Twelve-month primary patency (PP) was 68% (95% CI: 55%\u201379%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001). The pooled rate of freedom from clinically-driven target lesion revascularisation was 85% (95% CI: 80%\u201390%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001). No significant differences existed between acute, subacute and mixed subgroups. Procedure-related mortality was 0.5% (11 deaths in 2086 procedures from 17 studies) with most deaths occurring after adjunctive catheter-directed thrombolysis. Major adverse events occurred in 4% of procedures (95% CI: 1%\u20138%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001) and distal embolisation in 8% (95% CI: 5%\u201311%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .001). rPMT+ reduced length of stay by 1.7 days versus alternatives (95% CI: 3.3%\u20130.1 days,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .05). All outcomes demonstrated heterogeneity; GRADE assessment rated evidence certainty as low to very low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The evidence available from 24 real-world observational studies of 2954 procedures supports the use of rPMT+ in acute limb ischaemia and SLI \u2013 delivering an overall pooled TS rate of 98% and AFS rate of 96% with no significant differences between acute, subacute and mixed subgroups. rPMT+ is associated with shorter hospital stays than either surgery or thrombolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This systematic review and proportional meta-analysis synthesises 24 single-arm and comparative non-randomised studies encompassing nearly 3000 procedures to provide a comprehensive assessment of the safety and efficacy of rotational percutaneous mechanical thrombectomy in patients with acute and subacute lower limb ischaemia. It demonstrates that, when used for initial revascularisation prior to adjunctive angioplasty, stenting or limited thrombolysis, this endovascular approach delivers clinically valuable rates of technical success and amputation-free survival with notably high rates of freedom from clinically-driven target lesion revascularisation, acceptable primary patency, low procedural risk and significantly shorter hospital stays.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028261467201","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T06:10:07Z","timestamp":1786515007000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Rotational Percutaneous Mechanical Thrombectomy for Acute and Subacute Limb Ischaemia: A Systematic Review and Proportional Meta-Analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0461-7991","authenticated-orcid":false,"given":"Benedict","family":"Stanberry","sequence":"first","affiliation":[{"name":"Institute for Health Economics and Outcomes Research, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0777-7433","authenticated-orcid":false,"given":"Koen","family":"Deloose","sequence":"additional","affiliation":[{"name":"Az Sint Blasius, Dendermonde, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Gou\u00ebffic","sequence":"additional","affiliation":[{"name":"Groupe Hospitalier Paris Saint Joseph, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Goyault","sequence":"additional","affiliation":[{"name":"Strasbourg Cardiovascular Institute, Clinique Rhena, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Isernia","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera di Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Jackson","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Kucher","sequence":"additional","affiliation":[{"name":"Universit\u00e4ts Spital Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2647-9876","authenticated-orcid":false,"given":"Michael","family":"Lichtenberg","sequence":"additional","affiliation":[{"name":"Vascular Centre Clinic Arnsberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5207-9246","authenticated-orcid":false,"given":"James","family":"McCaslin","sequence":"additional","affiliation":[{"name":"The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8730-0406","authenticated-orcid":false,"given":"Bruno","family":"Migliara","sequence":"additional","affiliation":[{"name":"Ospedale P Pederzoli, Peschiera del Garda, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1733-6670","authenticated-orcid":false,"given":"Mark","family":"Portou","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3468-9945","authenticated-orcid":false,"given":"Christos","family":"Rammos","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9886-6213","authenticated-orcid":false,"given":"Caren","family":"Randon","sequence":"additional","affiliation":[{"name":"Universiteit Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Refaat","family":"Salman","sequence":"additional","affiliation":[{"name":"King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5912-8760","authenticated-orcid":false,"given":"Marc","family":"Sirvent","sequence":"additional","affiliation":[{"name":"Hospital General de Granollers, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2019.09.006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7237.764"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.54522\/jvsgbi.2025.177"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semvascsurg.2008.11.002"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.04.036"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.5758\/vsi.2019.35.1.4"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.21037\/cdt.2017.03.03"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002784.pub3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-011-0258-z"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2024.01.014"},{"key":"e_1_3_3_12_2","unstructured":"Becton Dickinson and Company. Refining atherectomy: Rotarex\u2122 rotational excisional atherectomy system. Published 2020. Accessed June 27 2026. https:\/\/ncvh.org\/wp-content\/uploads\/2020\/11\/BD-Refining-Atherectomy-Aspiration-Together.pdf"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s42155-018-0041-1"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v10.i10.145"},{"key":"e_1_3_3_15_2","unstructured":"Ontario Health. Mechanical thrombectomy for acute and subacute blocked arteries and veins in the lower limbs: a health technology assessment. Ont Health Technol Assess Ser. 2023;23(1):1-244. https:\/\/www.publications.gov.on.ca\/CL32555"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-021-01381-z"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01626-4"},{"key":"e_1_3_3_18_2","unstructured":"Stanberry B Monsalve Roquero B. A systematic review and proportional meta-analysis of percutaneous mechanical thrombectomy for acute and subacute limb ischaemia. PROSPERO. Published 2025. Accessed June 27 2026. https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251015846"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.4082\/kjfm.23.0034"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/jebm.12427"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.04.838"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jphys.2023.05.012"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2013-203104"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1017045"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2022.11.019"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-1952-0092"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.891649"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.831922"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0392-9590.22.04809-X"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2022.02.026"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2021.20100"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12959-021-00349-9"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.5152\/dir.2021.19403"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2020.03.014"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1024\/0301-1526\/a000883"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/1708538118813239"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2018.11.025"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.5114\/wiitm.2018.80006"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/1526602819840697"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S131503"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/2362769"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1177\/0003319716646682"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1024\/0301-1526\/a000495"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.4137\/CMC.S15231"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-012-0507-9"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-012-0152-x"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2013.08.016"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.rvi.0000094584.83406.3e"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.09.044"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.11.018"},{"key":"e_1_3_3_52_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199409000-00003"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0741-5214(05)80036-9"},{"key":"e_1_3_3_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0741-5214(94)70214-4"},{"key":"e_1_3_3_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.09.016"},{"key":"e_1_3_3_56_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2022.12.030"},{"key":"e_1_3_3_57_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2025.103616"},{"key":"e_1_3_3_58_2","doi-asserted-by":"crossref","unstructured":"Higgins J Thomas J Chandler J et al. Cochrane Handbook for Systematic Reviews of Interventions. 2nd ed. John Wiley & Sons; 2019. Accessed June 27 2026. https:\/\/www.cochrane.org\/authors\/handbooks-and-manuals\/handbook\/current","DOI":"10.1002\/9781119536604"},{"key":"e_1_3_3_59_2","doi-asserted-by":"publisher","DOI":"10.23736\/S0021-9509.25.13464-2"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261467201","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028261467201","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261467201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:59:11Z","timestamp":1786741151000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028261467201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,11]]},"references-count":58,"alternative-id":["10.1177\/15266028261467201"],"URL":"https:\/\/doi.org\/10.1177\/15266028261467201","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,11]]},"article-number":"15266028261467201"}}