Home > Journals > International Angiology > Past Issues > International Angiology 2017 August;36(4) > International Angiology 2017 August;36(4):340-5

CURRENT ISSUE
 

ARTICLE TOOLS

Publication history
Reprints
Cite this article as

INTERNATIONAL ANGIOLOGY

A Journal on Angiology


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,37


eTOC

 

ORIGINAL ARTICLE  


International Angiology 2017 August;36(4):340-5

DOI: 10.23736/S0392-9590.17.03797-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

A comparative study of percutaneous atherectomy for femoropopliteal arterial occlusive disease

Yongquan GU 1 , Mahmoud B., MALAS 2, Lixing QI 1, Lianrui GUO 1, Jianming GUO 1, Hengxi YU 1, Zhu TONG 1, Xixiang GAO 1, Jian ZHANG 1, Zhonggao WANG 1

1 Department of Vascular Surgery, XuanWu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing, China; 2 Johns Hopkins Bayview Medical Center, Baltimore, MD, USA


PDF  


BACKGROUND: SilverHawk™ directional atherectomy has been used to treat more than 300 thousand cases of lower extremity atherosclerotic occlusive disease in the world since it was approved by FDA in 2003. This study aimed to analyze the safety and effectiveness of symptomatic femoral popliteal atherosclerotic disease treated by directional atherectomy (DA).
METHODS: Clinical data of all consecutive patients treated with percutaneous atherectomy utilizing the SilverHawk™ plaque excision was retrospectively analyzed. The anatomic criteria of the atherosclerotic lesions were divided into four types: type I stenosis; type II occlusion; type III in-stent restenosis; type IV stent occlusion.
RESULTS: There were 160 patients treated during the study period. Intermittent claudication in 75 patients (47%), rest pain in 55 patients (34.5%) and tissue loss in 30 patients (18.5%). The number of patients was 72, 15, 49 and 24 in type I, II, III and IV lesions, respectively. Technical success rate was 98.6%, 93.3%, 97.9% and 91.7% in type I, II, III and IV lesions, respectively. Debris of intimal plaque was captured by protection device in 92 patients (71.3%). The mean follow-up period was 23.5±10.4 months. Restenosis rate of type I to IV lesions was 21%, 36%, 36% and 40% respectively. Restenosis rate in type I lesion was significantly lower than that in type III and IV lesions (P<0.05). Patients with tissue loss responded to revascularization as follow: type I, 11/13 healed or reduced (84.6%), type II, 3/3 patients improved (100%), type III, 5/6 patients improved (83.3%) and type IV 4/4 healed (100%). In type IV group, four patients had in-stent thrombosis found by postoperative Duplex ultrasonography. They all underwent DA after catheter-directed thrombolysis with good angiographic results.
CONCLUSIONS: Percutaneous DA is safe and effective for both de-novo atherosclerotic and in-stent stenotic or occlusive lesions. Thrombolysis before plaque excision is recommended in case of in-stenting thrombosis.


KEY WORDS: Atherectomy - Stents - Thrombosis - Embolic protection devices

top of page

Publication History

Issue published online: June 8, 2017
Article first published online: February 9, 2017
Manuscript accepted: January 26, 2017
Manuscript received: November 27, 2016

Cite this article as

Gu Y, Malas MB, Qi L, Guo L, Guo J, Yu H, et al. A comparative study of percutaneous atherectomy for femoropopliteal arterial occlusive disease. Int Angiol 2017;36:340-5. DOI: 10.23736/S0392-9590.17.03797-X

Corresponding author e-mail

15901598209@163.com