Rotational Percutaneous Mechanical Thrombectomy for Acute and Subacute Limb Ischaemia: A Systematic Review and Proportional Meta-Analysis

Objective Rotational percutaneous mechanical thrombectomy with adjunctive angioplasty, stenting or limited thrombolysis (rPMT+) has become commonplace in the treatment of acute and subacute limb ischaemia. This systematic review and proportional meta-analysis synthesises the available evidence on its safety and efficacy. Data Sources MEDLINE, Embase and the Cochrane Library. ≥ Review Methods We searched for studies (≥10 patients) published since 1 January 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. GRADE evidence profiles were developed for each outcome of interest. Results Twenty-four studies – seven comparative and 17 single arm – containing 2,954 procedures (2,697 rPMT+, 257 controls) met eligibility criteria. There were no randomised controlled trials. The pooled technical success (TS) rate for rPMT+ was 98% (95% CI: 97-100%, p