Atherectomy vs Other Modalities for Treatment During Peripheral Vascular Intervention
Mohsin Chowdhury1, Eric A Secemsky2
1Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Baker 4, Boston, MA, 02215, USA.
Current Cardiology Reports
|May 10, 2022
Summary
Peripheral atherectomy offers a minimally invasive approach for calcified atheroma, potentially improving outcomes in peripheral artery disease (PAD). However, more high-quality studies are needed to confirm its superiority over traditional treatments.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Medical Device Technology
Background:
- Calcified atheroma presents challenges in peripheral vascular intervention, with standard balloon angioplasty and stenting often yielding suboptimal results.
- These limitations include vessel recoil, inadequate luminal gain, and poor stent expansion, necessitating alternative treatment strategies.
Purpose of the Study:
- To review available endovascular atherectomy devices for peripheral artery disease (PAD).
- To compare their mechanisms of action, summarize clinical data, and discuss future prospects.
- To evaluate the role of atherectomy compared to other PAD treatment modalities.
Main Methods:
- Review of current endovascular atherectomy devices in clinical practice.
- Comparison of device mechanisms, advantages, and disadvantages.
- Summary of published data on indications and outcomes.
Main Results:
- A variety of atherectomy devices exist, each with unique features.
- Limited high-quality data currently exists to definitively prove atherectomy's superiority over standard balloon angioplasty and stenting.
- Emerging evidence suggests potential benefits when used with drug-coated balloons, possibly improving patency rates.
Conclusions:
- Peripheral atherectomy is a promising minimally invasive option for PAD, potentially reducing the need for bailout stenting and enhancing drug delivery.
- Further investment in robust clinical trials is essential to establish definitive evidence supporting its widespread adoption and cost-effectiveness.
- High-quality data is required to confirm the superiority of atherectomy as an adjunctive treatment for PAD.
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