Hand-Assisted Rotational Atherectomy for Severe and Long Superficial Femoral Artery Calcification: A Step-by-Step
Jen-Kuang Lee1, Hung-Chi Su2, Po-Chao Hsu3
1Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
JACC. Case Reports
|July 18, 2025
Summary
Hand-assisted rotational atherectomy (HARA) offers a safe and effective method for treating calcified superficial femoral artery (SFA) lesions. This technique improves procedural success and optimizes outcomes when combined with drug-coated balloons or stents.
Area of Science:
- Vascular surgery
- Interventional cardiology
- Endovascular techniques
Background:
- Superficial femoral artery (SFA) calcification poses challenges for endovascular treatment.
- Optimal revascularization is crucial for improving patient outcomes.
Observation:
- Hand-assisted rotational atherectomy (HARA) utilizes a 2.0-mm burr for debulking.
- Key procedural steps include ultrasound-guided access, controlled atherectomy, manual compression, and adjunctive therapy.
- Potential pitfalls like burr entrapment can be managed with careful technique.
Findings:
- HARA demonstrates safety, efficacy, and reproducibility in treating severely calcified SFA lesions.
- The technique enhances procedural success rates.
- Optimized outcomes are achieved when HARA is combined with drug-coated balloon angioplasty or drug-eluting stent deployment.
Implications:
- HARA represents an innovative approach to complex SFA interventions.
- This method facilitates better lesion preparation and treatment.
- Improved outcomes contribute to enhanced limb salvage and quality of life for patients with peripheral artery disease.
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