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Reverse flow-controlled atherectomy treatment using the JETSTREAM atherectomy device for reducing distal

Yuta Kato1, Shunsuke Kojima1, Tatsuya Nakama1

  • 1Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Chiba, Japan.

Journal of Vascular Surgery Cases and Innovative Techniques
|March 19, 2026
PubMed
Summary
This summary is machine-generated.

Reverse flow-controlled atherectomy treatment (R-CAT) offers enhanced embolic protection for complex femoropopliteal lesions. This new method improves procedural safety by reducing distal embolization during atherectomy.

Keywords:
Distal embolizationEndovascular therapyJETSTREAM atherectomy deviceLower extremity arterial diseaseReverse flow-controlled treatment

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Devices

Background:

  • Severely calcified femoropopliteal lesions present significant technical challenges for atherectomy.
  • Distal embolization (DE) is a primary complication, particularly concerning in cases with poor tibial runoff.

Purpose of the Study:

  • To introduce and evaluate the safety and feasibility of a novel technique, reverse flow-controlled atherectomy treatment (R-CAT), for managing complex femoropopliteal lesions.
  • To assess R-CAT's efficacy in preventing distal embolization during atherectomy.

Main Methods:

  • Development of R-CAT using the JETSTREAM system, incorporating retrograde catheter insertion with distal flow arrest and aspiration.
  • Application of R-CAT in a case study involving a patient with long, heavily calcified femoropopliteal lesions and limited tibial runoff.

Main Results:

  • The R-CAT procedure in the representative case achieved both technical and procedural success.
  • No complications or instances of distal embolization (DE) were observed during the procedure.

Conclusions:

  • R-CAT is a feasible and safe approach for performing atherectomy in complex femoropopliteal disease.
  • This technique effectively reduces distal embolization, thereby enhancing overall procedural safety.