Percutaneous transluminal atherectomy of the superficial femoral and popliteal arteries: long-term results in 48 patients

• Published in: Cardiovascular and interventional radiology 1994-11, Vol.17 (6), p.312-318
• Main Authors: SAVADER, S. J, VENBRUX, A. C, MITCHELL, S. E, TREROTOLA, S. O, MEI-CHENG WANG, SNEED, T. A, TUDDER, G. B, ROSENBLATT, M, LUND, G. B, OSTERMAN, F. A
• Format: Article
• Language: English
• Subjects: Actuarial Analysis; Adult; Aged; Aged, 80 and over; Arteriosclerosis - diagnostic imaging; Arteriosclerosis - therapy; Atherectomy - adverse effects; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Femoral Artery - diagnostic imaging; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; Popliteal Artery - diagnostic imaging; Radiography; Recurrence; Retrospective Studies; Vascular Patency
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/bf00203949

Evaluate retrospectively the long-term primary patency of directional atherectomy (DA) in the femoropopliteal arteries. DA was used alone in 59 patients (47%) or in combination with predilatation to allow passage of the device (43%) or after thrombolysis (10%) to treat 127 (93%) excentric atherosclerotic stenoses and nine (7%) occlusions of the femoropopliteal arteries. Forty-eight patients were followed by telephone interview, scheduled outpatient visits, color-flow Doppler evaluation, and angiography for 1-36 months (mean 16.9 months). Technical success (reduction of the stenosis or occlusion to less than 30% luminal diameter) was achieved in 110 lesions (80.3%) during 48 procedures in 37 patients. Mean luminal diameter was increased 54% with a concomitant increase in mean ankle/brachial indices of 0.33. According to Kaplan-Meier survival curves, patency at 12 and 24 months was 88% and 75%, respectively. When patients who retained patency but developed restenosis were excluded, the probability of patency at 12, 24, and 36 months was 76%, 58%, and 32%, respectively. Major and minor complications occurred in 15 (21.4%) procedures each for a total complication rate of 42.8%. Based on our results, DA is an effective method for percutaneous treatment of atherosclerotic disease involving the femoropopliteal arteries. It has similar patency but a relatively high complication rate compared with PTA.