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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.

|June 1, 1992

Summary

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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.

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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.