Infrainguinal directional atherectomy: long-term follow-up and comparison with percutaneous transluminal angioplasty.
OBJECTIVE
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).


METHODS
Eight-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.
Wildenhain
P M
PM
Department of Radiological Sciences and Diagnostic Imaging, Shadyside Hospital, Pittsburgh, PA 15232.
Wholey
M H
MH
Jarmolowski
C R
CR
Hill
K L
KL
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000628:therapy*; D017073:Atherectomy; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery; D011859:Radiography; D012189:Retrospective Studies; D014654:Vascular Patency