[Percutaneous peripheral atherectomy in arterial occlusive disease. Angiographic and clinical acute and long-term results].
130 arteriosclerotic lesions--10 in the iliac, 109 in the superficial femoral, 10 in the popliteal and 1 in the anterior tibial artery--were treated by percutaneous atherectomy in 80 patients (62 men and 18 women: mean age 65 +/- 10 years). 23 of the lesions were concentric, 65 eccentric stenoses, while 42 were fully occlusive. 32 patients were in stage IIb (after Fontaine), 24 in stage IIa and 12 each in stage III or IV. Most of the stenoses were not suitable for conventional balloon dilatation because of their primary morphology. A good early angiographic result (residual stenosis less than 50%) was achieved in 94% of lesions. Mean stenosis degree was reduced from 85 +/- 12% to 12 +/- 10% (occlusions from 100% to 9 +/- 9%). The Doppler index increased from 0.6 +/- 0.18 to 0.85 +/- 0.15 (P less than 0.01). Follow-up angiography after 6 months in 104 lesions demonstrated an average stenosis degree of 33 +/- 25% (occlusions 44 +/- 28%). 26 of the 104 re-studied lesions fulfilled the criterion for re-stenosis (greater than 50%): six concentric ones and five eccentric ones, as well as 15 occlusions. These findings indicate that peripheral atherectomy can be employed with good short and long-term results even in morphologically unfavourable, markedly eccentric or calcified lesions and occlusions.
Medizinische Klinik I, Klinikum Grosshadern, Universität München.
P
P
Gonschior
B
B
Höfling
D
D
Backa
G
G
Bauriedel
A
A
von Pölnitz
D000208:Acute Disease; D000368:Aged; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery; D013997:Time Factors
Perkutane periphere Atherektomie bei arterieller Verschlusskrankheit. Angiographische und klinische Akut- und Langzeitergebnisse.