[Angiography and functional results and histologic findings following percutaneous atherectomy in patients with arterial occlusive disease].
In this study we report on the atherectomy technique, acute and long-term data, and histological findings of excised specimens from patients with peripheral vascular disease treated with the Simpson atherectomy catheter. Forty patients with a total of 72 lesions of the iliac (n = 5), superficial femoral (n = 62), and popliteal (n = 5) arteries could be treated; five patients had rest pain and two had gangrene. The primary success rate (of all lesions, including total occlusions and longer stenoses) was over 90%. The percent of stenosis decreased from 87.2 +/- 19.9% to 16.6 +/- 15.5%; the claudication distance improved from 80.5 +/- 65.7 m to 152.8 +/- 80.3 m; the Doppler index (leg/arm) increased from 0.57 +/- 0.17 to 0.81 +/- 0.16. At 6 months the mean walking distance and Doppler index remained stable from post-atherectomy; the mean percent of stenosis had increased to 35.7 +/- 30.9%. The angiographic restenosis rate (defined as stenosis greater than 70%) was 21% with a clear difference found depending on the primary morphology of the lesion: in eccentrics 5%, concentrics 27%, and total occlusions 42%, thereby allowing categorization of the suitability of a primary lesion for atherectomy. Histologically, restenoses showed more cellular proliferation and organized thrombus as compared to their primary stenoses; further investigations (cell culture, immunohistochemistry, and electron microscopy) are underway.(ABSTRACT TRUNCATED AT 250 WORDS)
Höfling
B
B
Medizinische Klinik I, Klinikum Grosshadern, Ludwig-Maximilians-Universität München.
von Pölnitz
A
A
Backa
D
D
Meissner
R
R
von Arnim
T
T
Jauch
G
G
Remberger
K
K
D000800:Angioplasty, Balloon / Q000379:methods*; D001162:Arteriosclerosis Obliterans / Q000473:pathology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000473:pathology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D012008:Recurrence
Angiographische und funktionelle Ergebnisse sowie histologische Befunde nach perkutaner Atherektomie bei Patienten mit arterieller Verschusskrankheit.