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Peripheral directional atherectomy: 4-year experience.
D Kim1, L E Gianturco, D H Porter
1Department of Radiology, Beth Israel Hospital, Harvard Medical School, Boston, MA 02215.
Radiology
|June 1, 1992
Summary
Directional atherectomy effectively treats peripheral vascular lesions with high technical success. However, diabetic patients experienced a higher restenosis rate, indicating a need for tailored treatment strategies.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease
Background:
- Peripheral vascular lesions significantly impact patient mobility and quality of life.
- Current treatment options aim to restore vessel patency and prevent limb-threatening ischemia.
Purpose of the Study:
- To evaluate the efficacy and safety of directional atherectomy for peripheral vascular lesions.
- To assess factors influencing restenosis and long-term patency.
Main Methods:
- Retrospective analysis of 85 procedures in 77 patients undergoing directional atherectomy (with or without angioplasty).
- Lesion locations included iliac arteries, infrainguinal arteries, and bypass grafts.
- Follow-up included noninvasive vascular studies and clinical examination over a mean of 13.5 months.
Main Results:
- Technical success (stenosis ≤30%) was achieved in 92% of procedures.
- Overall complication rate was 21%, primarily minor puncture site issues.
- 1-, 2-, and 3-year patency rates for atherectomy alone were 92%, 84%, and 84%, respectively.
- Diabetic patients showed a significantly higher restenosis rate (P < .03).
Conclusions:
- Directional atherectomy is a safe and effective treatment for diverse peripheral vascular lesions.
- Long-term patency is not significantly affected by lesion characteristics like calcification or location.
- Diabetes mellitus is identified as a risk factor for restenosis after atherectomy.