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[Long-term results of percutaneous atherectomy in peripheral arterial occlusive disease]
H Lugmayr1, O Pachinger, M Deutsch
1Abteilung Radiologie I, Krankenhaus der Barmherzigen Schwestern vom Hl. Kreuz, Wels.
Insights
Simpson
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease
Context:
- Peripheral vascular disease (PVD) affects numerous patients, necessitating effective treatment strategies.
- Percutaneous atherectomy offers a minimally invasive approach for treating PVD.
- Evaluating the long-term outcomes of Simpson's atherectomy technique is crucial for clinical decision-making.
Purpose:
- To analyze the indications and long-term results of Simpson's atherectomy for peripheral vascular disease.
- To assess factors influencing arterial patency after percutaneous atherectomy.
- To compare the efficacy of atherectomy with historical balloon angioplasty data.
Summary:
- A retrospective analysis of 94 patients with 132 peripheral vascular lesions treated with Simpson's atherectomy showed a 95% primary success rate.
- Cumulative patency rates were 69% at 12 months and 42% at 24 months.
- Higher patency was observed in stenoses (73%) versus occlusions (51%), and in diabetics (71%) compared to non-diabetics (62%). Results suggest residual stenoses post-balloon dilation are optimal indications.
Impact:
- This study provides valuable long-term outcome data for Simpson's atherectomy in peripheral vascular disease.
- Findings highlight specific patient subgroups and lesion types that may benefit most from this intervention.
- The comparison with balloon angioplasty suggests a refined role for atherectomy, particularly for residual stenoses.
Abstract:
In a retrospective study the indications and the long-term results of percutaneous atherectomy of a nonselected group of patients were analysed. From March 1988 to November 1989, 94 patients suffering from peripheral vascular disease were treated using Simpson's atherectomy technique. There were 132 lesions, 101 stenoses and 31 occlusions in a total of 94 patients. The primary success rate was 95%. After 12 months of follow-up the cumulative patency rate was 69% and after 24 months, 42%. After a follow-up period of 15 months patent arteries and recurrences were recorded and the results used to analyse the factors that influence patency after Simpson atherectomy. The patency rate is 71% in diabetics and 62% in non-diabetics. It is 51% in occlusions and 73% in stenoses. The patency rate in patients with fair runoff is 69%, in patients with poor runoff 60%. Comparing these results with historical studies concerning balloon dilation the results are poor. Residual stenoses after balloon dilation seem to be the optimal indication for percutaneous atherectomy.