Atherectomy of Heavily Calcified Femoropopliteal Stenotic Lesions

Effective endovascular treatment of calcified femoropopliteal disease with directional atherectomy and distal embolic protection: Final results of the DEFINITIVE Ca++ trial

“…A single‐center, prospective study was recently published on the use of the SilverHawk device to treat calcified femoropopliteal lesions . In 88% of cases, <30% residual diameter stenosis was achieved with SilverHawk alone; in every case, this was achieved with the use of adjunctive therapy including four stents (10.5%).…”

Drug-eluting balloons for femoropopliteal lesions show better performance in de novo stenosis or occlusion than in restenosis

“…The results are better than after standard PTA, with TLR between 39% and 78% after PTA 16,17 and 65% at 6 months after cutting balloon. 18 The results after DEB are better or similar to technically more demanding strategies such as cryoplasty and stenting, [19][20][21] rotational atherectomy, directed atherectomy, and laser atherectomy, with TLR of 42%, 22 31% to 75%, [23][24][25][26][27] and 48% to 51%, 28,29 respectively. Also the results of directional atherectomy alone [24][25][26][27] or combined with heparin-coated stent grafts 30 could not reach better results at 12 months, with 60% requiring additional PTA.…”

“…18 The results after DEB are better or similar to technically more demanding strategies such as cryoplasty and stenting, [19][20][21] rotational atherectomy, directed atherectomy, and laser atherectomy, with TLR of 42%, 22 31% to 75%, [23][24][25][26][27] and 48% to 51%, 28,29 respectively. Also the results of directional atherectomy alone [24][25][26][27] or combined with heparin-coated stent grafts 30 could not reach better results at 12 months, with 60% requiring additional PTA. 26 The problem of recurrent in-stent RE might not be solved with stenting, debulking technology, or DEB alone; therefore, appropriately powered trials are required to evaluate the role of different technologies and strategies to improve the results of treatment of RE in the peripheral arteries.…”

Effect of hospital volume on outcomes of percutaneous peripheral atherectomy – An observational analysis from National Inpatient Sample

“…At one-year follow-up, PPA has shown a significant decrease in Rutherford score, an increase in Ankle Brachial Index (ABI), and reasonable patency rates in heavily calcified vessels. 17 In the posthoc analysis from multi-center-randomized DEFINITIVE LE trial in two subgroups at the end of one-year follow-up, the freedom from amputation was 97.1%. 18 Although these data support the use of atherectomy devices, they should be interpreted with caution due to inherent limitations of these data sets such as small sample size, 19 the absence of comparative arm, 20 and restricted patient population.…”

“…At one-year follow-up, PPA has shown a significant decrease in Rutherford score, an increase in Ankle Brachial Index (ABI), and reasonable patency rates in heavily calcified vessels. 17 In the Table 3. Multivariate logistic analysis for predictors of (A) primary outcome (in-hospital mortality and amputations) of peripheral percutaneous atherectomy from NIS dataset from year 2012. posthoc analysis from multi-center-randomized DEFINITIVE LE trial in two subgroups at the end of one-year follow-up, the freedom from amputation was 97.1%.…”