Percutaneous atherectomy in iliac, femoral and popliteal arteries

Abstract

A recently developed catheter [2, 3] allows to remove atherosclerotic plaques percutaneously: After the tubular housing (Fig. 1) at the distal end of a 7or 9 F atherectomy catheter has been located in the stenotic area, the plaque material can bulge into the excavation. A rotating (2000 rpm) cutter will then be advanced to remove the wotruding part of the plaque. After having withdrawn the catheter, the captured cylinder can be removed and investigated. We treated five patients with the following lesions: one subtotal eccentric iliac stenosis, three single or multiple femoral stenoses and one patient with an acute total occlusion of the popliteal artery. The latter patient was initially recanalized with a balloon catheter as used for percutaneous transluminal coronary angioplasty. All patients were symptomatic (pain at rest in two, claudication distance 20 to 50 m in three). All five patients were recanalized without complications. Angiographically (Fig. 2) there were no residual stenoses in three patients and 30 to 40% residual stenoses in two cases. The Doppler ankle/arm-index increased from 0,5 to 0,9. The removed tissues showed endothelium, connective tissue, calcification and old or fresh thrombi. Four patients improved to age-specific load capacities, one remained symptomatic with a 40 m claudication. No clinical signs of restenoses occurred during the follow-up period of one to 18 weeks. The percutaneous treatment of peripheral arterial occlusive disease is limited by a high rate of restenoses up to 46% after five years [1, 4]. The removal of plaque material may lead to a lower rate of restenoses. We could demonstrate an excellent acute result by using the new atherectomy catheter [2, 3] and did not see clinical signs of restenoses during early follow-up. Fig. 2. Femoral stenosis before and after treatment

DOI: 10.1007/BF01721041

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@article{Hoefling1987PercutaneousAI, title={Percutaneous atherectomy in iliac, femoral and popliteal arteries}, author={Berthold Hoefling and John B. Simpson and Klaus Remberger and Lutz Lauterjung and D. Backa}, journal={Klinische Wochenschrift}, year={1987}, volume={65}, pages={528-528} }