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[Peripheral arterial recanalization using a Kensey catheter]
D Desbrosses1, E Torres, D Barrionuevo
1Service de chirurgie cardio-vasculaire, CHU de Strasbourg.
Journal Des Maladies Vasculaires
|January 1, 1990
Summary
Rotary atherectomy effectively treated superficial femoral artery disease, achieving 76% satisfactory permeability. Mid-term results showed 80% permeability at six months, indicating a promising treatment for peripheral artery disease.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Background:
- Superficial femoral artery (SFA) disease significantly impacts patient mobility and quality of life.
- Traditional treatment options for SFA occlusions have limitations, especially in complex or calcified lesions.
- Rotary atherectomy offers a minimally invasive approach to address challenging SFA obstructions.
Purpose of the Study:
- To evaluate the efficacy and safety of rotary atherectomy for treating superficial femoral artery occlusions.
- To assess procedural success rates, including lesion traversal and achievement of residual stenosis.
- To determine the mid-term patency rates and clinical outcomes following rotary atherectomy.
Main Methods:
- A cohort of 44 patients with symptomatic SFA occlusions underwent treatment with rotary atherectomy between June 1988 and September 1989.
- Vascular echography was used pre-procedure to assess intraluminal calcification.
- Rotary atherectomy was often combined with conventional balloon angioplasty.
- Follow-up included day-3 angiography and clinical assessment of lower limb/upper limb Doppler index.
Main Results:
- Successful lesion traversal was achieved in 87% of cases (40/46), even in lesions impermeable to traditional guidewires.
- Satisfactory permeability (residual stenosis <30%) was obtained in 76% of patients at hospital discharge.
- The mean lower limb/upper limb Doppler index improved significantly from 0.44 to 0.89 post-treatment.
- Mid-term permeability at 6 months was 80% among primary successes, with a low rate of complications like embolism (2 cases).
Conclusions:
- Rotary atherectomy is an effective and safe endovascular technique for treating superficial femoral artery occlusions, particularly in calcified or complex lesions.
- The procedure leads to significant improvement in limb perfusion and satisfactory mid-term patency rates.
- This approach represents a valuable alternative to surgical intervention for selected patients with peripheral artery disease.