Infrainguinal directional atherectomy: Long-term follow-up and comparison with percutaneous transluminal angioplasty |
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Authors: | Philip M Wildenhain Mark H Wholey Chester R Jarmolowski Katherine L Hill |
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Institution: | (1) Pittsburgh Vascular Institute, Department of Radiological Sciences and Diagnostic Imaging, Shadyside Hospital, 5230 Centre Avenue, 15232 Pittsburgh, PA, USA |
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Abstract: | Purpose To assess the long-term results of directional atherectomy (DA) for femoropopliteal artery atherosclerotic lesions and to compare the results to those previously reported for percutaneous transluminal balloon angioplasty (PTA).Materials and Methods Eighty-four percutaneous DA procedures performed on 75 patients between July 1988 and August 1992 were retrospectively reviewed and evaluated for technical and initial clinical success. Long-term patency was assessed with a combination of ankle-brachial index measurements and angiography.Results Initial technical success was achieved in 77 of 84 procedures (92%). Follow-up of 72 patients was obtained, including 74 of the 84 (88%) DA procedures with a mean follow-up of 17.4 months (range 1–48 months). Primary patency was 78% at 1 year and 57% at 2 years. Patients with diabetes, complete luminal occlusion, or limb salvage situations had significantly lower patency.Conclusions Femoropopliteal artery DA can be performed safely with a high technical and initial clinical success. Long-term patency is improved when compared with published series for PTA. With this improvement in mind, DA may have a place in the treatment of focal infrainguinal stenoses. |
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Keywords: | Arteries extremities Stenosis or obstruction Transluminal angioplasty Femoral artery Popliteal artery Catheters and catheterization |
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