Phoenix atherectomy for patients with peripheral artery disease
Sorin Giusca1, Saskia Hagstotz1, Michael Lichtenberg2
1GRN Hospital Weinheim, Cardiology and Vascular Medicine, Weinheim, Germany.
Summary
The Phoenix atherectomy is a safe endovascular treatment for complex peripheral artery disease (PAD) lesions. It shows acceptable rates of target lesion revascularisation (TLR) and low bail-out stenting, improving outcomes for PAD patients.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Background:
- Peripheral artery disease (PAD) affects millions globally, necessitating effective treatments for complex and calcified lesions.
- Endovascular atherectomy offers a minimally invasive approach to plaque removal in PAD.
- The Phoenix atherectomy system is a newer device for PAD treatment.
Purpose of the Study:
- To evaluate the safety and long-term effectiveness of the Phoenix atherectomy.
- To assess outcomes in patients with complex and calcified lesions in PAD.
- To analyze device-related complications and revascularization rates.
Main Methods:
- A consecutive series of all-comer PAD patients underwent Phoenix atherectomy.
- Device safety was assessed by monitoring perforations and distal embolizations.
- Lesion calcification (PACSS) and complexity (TASC) were categorized.
- Clinically driven target lesion revascularization (TLR) was the primary effectiveness endpoint.
Main Results:
- 558 lesions in 402 patients were treated, with a mean follow-up of 15.7 months.
- The majority of lesions were complex (TASC C/D, 82%) and calcified (PACSS ≥2, 80%).
- Low rates of perforation (1%) and asymptomatic embolization (2%) were observed.
- Freedom from TLR was 87.5% for claudication and 82.3% for critical limb-threatening ischemia (CLTI).
Conclusions:
- The Phoenix atherectomy is a safe endovascular option for complex PAD lesions.
- The device demonstrates a low rate of bail-out stenting.
- Clinically acceptable target lesion revascularization rates were achieved in PAD patients.
More Related Videos
07:25Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
Published on: September 22, 2020
3.5K
10:46Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology
Published on: May 26, 2015
13.5K
Related Concept Videos
01:27Peripheral Artery Disease III: Interprofessional Care
42
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
42
01:23Peripheral Artery Disease V: Postoperative Nursing Management
35
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
35
01:30Peripheral Artery Disease I: Introduction
53
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
53
01:26Peripheral Artery Disease IV: Nursing Management
72
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
72
01:26Atherosclerosis III: Management
54
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
54
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
44
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
44