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

Savader, Scott J.; Venbrux, Anthony C.; Mitchell, Sally E.; Trerotola, Scott O.; Wang, Mei Cheng; Sneed, Thomas A.; Tudder, George B.; Rosenblatt, Melvin; Lund, Gunnar B.; Osterman, Floyd A.

doi:10.1007/bf00203949

Cited by 19 publications

(3 citation statements)

References 13 publications

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“…Therefore, new devices have been developed to create a smooth vessel wall less susceptible to superimposed thrombus and myointimal hyperplasia. Directional atherectomy (DA) is the most used alternative and the patency rates for short lesions are equal to or even better than those for PTA [18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Directional Atherectomy Studied by Intravascular Ultrasound in Femoropopliteal Artery Stenosis

Tielbeek

Vroegindeweij

Gussenhoven

et al. 1997

Cardiovasc Intervent Radiol

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Section: Discussionmentioning

confidence: 99%

Evaluation of Directional Atherectomy Studied by Intravascular Ultrasound in Femoropopliteal Artery Stenosis

Tielbeek

Vroegindeweij

Gussenhoven

et al. 1997

Cardiovasc Intervent Radiol

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“…Compared to PTA and stent implantation, they offer the theoretical advantages of eliminating stretch injury on arterial walls, limiting acute dissection (and the need for adjunctive stenting), and reducing elastic recoil, thereby potentially reducing the rate of restenosis. Historically, however, neither rotational nor directional atherectomy, whether used alone or with adjunctive PTA, has shown any significant long-term benefit over PTA alone in coronary or peripheral arteries, 12,28–37 despite promising results in some single-center studies. 38…”

Section: History Of Atherectomy In the Coronary And Infrainguinal Arteriesmentioning

confidence: 99%

Atherectomy for Infrainguinal Peripheral Artery Disease

Garcia¹,

Lyden²

2009

Journal of Endovascular Therapy

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Compared to conventional percutaneous transluminal angioplasty (PTA) and stent implantation for arterial occlusive diseases, atherectomy offers the theoretical advantages of eliminating stretch injury on arterial walls and reducing the, rate of restenosis. Historically, however, neither rotational nor directional atherectomy, whether used alone or with adjunctive PTA, has shown any significant long-term benefit over PTA alone in the coronary or peripheral arteries. However, the SilverHawk Plaque Excision System has produced positive results in single-center prospective registries of patients with femoropopliteal and infrainguinal lesions, with reduced adjunctive PTA, minimal adjunctive stenting, and competitive 6-month and 12-month patency rates. In the observational nonrandomized TALON (Treating Peripherals with SilverHawk: Outcomes Collection) registry, freedom from target lesion revascularization was 80% for 87 patients at 12 months. Questions remaining for further research with this device include more accurate determination of an event rate for distal embolization, the appropriate use of distal protection, the value of and appropriate circumstances for adjunctive angioplasty, and definitive patency and clinical outcomes. Other atherectomy devices are discussed.

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“…Despite any superior efficacy over only angioplasty alone in the coronary vasculature, there remains an interest in atherectomy for use in the peripheral vascular space. Given that current angioplasty and stenting data have not shown as much long‐term success, there is a growing interest in alternative athero‐ablative technologies 7–17 . The peripheral arteries, in particular the infra‐inguinal territory, undergo many dynamic forces that make translation of the coronary interventional literature to the peripheral vasculature not as relevant.…”

Section: Introductionmentioning

confidence: 99%

Peripheral Atherectomy: A Critical Review

Bunting

Garcia

2007

J Interven Cardiology

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Atherectomy is experiencing increased interest from endovascular specialists as a therapeutic treatment in the peripheral arteries. Long studied in the coronary vasculature, atherectomy has several theoretical advantages that make it uniquely suited for the peripheral circulation. In particular, infra-inguinal peripheral arterial disease experiences physiologic stresses and forces that have made traditional percutaneous coronary treatments such as angioplasty and stenting not as successful. Restenosis has been a major problem for angioplasty and stenting alone. The SilverHawk atherectomy device has favorable short-term data but important longer-term data are limited and need further study. Laser atherectomy also has favorable applications in niche patients but the number of studies is limited. Unfortunately, athero-ablative technologies for peripheral arterial disease require more definitive objective data regarding 12-month and longer-term outcomes in order to obtain widespread scientific acceptance.

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

Abstract: 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.

Cited by 19 publications

References 13 publications

Evaluation of Directional Atherectomy Studied by Intravascular Ultrasound in Femoropopliteal Artery Stenosis

Evaluation of Directional Atherectomy Studied by Intravascular Ultrasound in Femoropopliteal Artery Stenosis

Atherectomy for Infrainguinal Peripheral Artery Disease

Peripheral Atherectomy: A Critical Review

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