Atherectomy in complex infrainguinal lesions: a review.

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Therapies

Background:

• Endovascular revascularization is a primary treatment for femoropopliteal disease.
• Nitinol stenting improves patency but has limitations like in-stent restenosis and fractures.
• Atherectomy offers plaque debulking to potentially avoid stenting.

Purpose of the Study:

• To review and analyze the performance of various atherectomy techniques.
• To evaluate atherectomy for complex femoropopliteal lesions.
• To compare different atherectomy methods in treating challenging arterial disease.

Main Methods:

• Non-systematic literature review.
• Analysis of direct, orbital, laser, and rotational atherectomy.
• Focus on complex lesions: long, calcified, occlusions, and in-stent restenosis.

Main Results:

• Atherectomy techniques aim to reduce plaque burden.
• Potential to decrease angioplasty pressure requirements.
• May circumvent the need for stent placement and associated complications.

Conclusions:

• Atherectomy is a viable option for complex femoropopliteal lesions.
• Different atherectomy modalities show varied performance.
• Further research is needed to optimize atherectomy use in endovascular treatment.