Markedly eccentric peripheral vascular stenoses: percutaneous atherectomy with an endomyocardial biopsy device

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Eccentric stenoses in lower limb arteries pose significant therapeutic challenges.
• Current percutaneous transluminal angioplasty (PTA) techniques have limitations for certain lesion types.
• Novel atherectomy devices are needed to improve treatment outcomes for peripheral artery disease.

Purpose of the Study:

• To evaluate the efficacy and safety of percutaneous atherectomy using an endomyocardial biopsy device.
• To assess the treatment of eccentric stenoses in lower limb arteries.
• To compare outcomes with conventional PTA.

Main Methods:

• Percutaneous atherectomy was performed in 23 patients with 27 eccentric lower limb artery stenoses.
• An endomyocardial biopsy device was utilized for lesion treatment.
• Histopathologic examination of extracted particles was conducted.

Main Results:

• Mean percentage stenosis decreased from 82% to 14% (P < .001), indicating high efficacy.
• Histopathology confirmed the absence of media or adventitial tissue in extracted particles.
• Technical success and complication rates were comparable to conventional PTA for similar lesions.

Conclusions:

• Percutaneous atherectomy with an endomyocardial biopsy device is a safe and effective treatment for eccentric lower limb artery stenoses.
• The procedure achieves significant stenosis reduction with a favorable safety profile.
• This technique offers an alternative to conventional PTA, particularly for challenging eccentric lesions.