title: Percutaneous transluminal atherectomy of the superficial femoral and popliteal arteries: long-term results in 48 patients.
abstract: OBJECTIVE
  Evaluate retrospectively the long-term primary patency of directional atherectomy (DA) in the femoropopliteal arteries.
  
  
  METHODS
  DA was used alone in 59 patients (47%) or in combination with predilatation to allow passage of the device (43%) or after thrombolysis (10%) to treat 127 (93%) excentric atherosclerotic stenoses and nine (7%) occlusions of the femoropopliteal arteries. Forty-eight patients were followed by telephone interview, scheduled outpatient visits, color-flow Doppler evaluation, and angiography for 1-36 months (mean 16.9 months).
  
  
  RESULTS
  Technical success (reduction of the stenosis or occlusion to less than 30% luminal diameter) was achieved in 110 lesions (80.3%) during 48 procedures in 37 patients. Mean luminal diameter was increased 54% with a concomitant increase in mean ankle/brachial indices of 0.33. According to Kaplan-Meier survival curves, patency at 12 and 24 months was 88% and 75%, respectively. When patients who retained patency but developed restenosis were excluded, the probability of patency at 12, 24, and 36 months was 76%, 58%, and 32%, respectively. Major and minor complications occurred in 15 (21.4%) procedures each for a total complication rate of 42.8%.
  
  
  CONCLUSIONS
  Based on our results, DA is an effective method for percutaneous treatment of atherosclerotic disease involving the femoropopliteal arteries. It has similar patency but a relatively high complication rate compared with PTA.
authors.affiliation: Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21287.
authors.forename: S J
authors.initials: SJ
authors.lastname: Savader
authors.forename: A C
authors.initials: AC
authors.lastname: Venbrux
authors.forename: S E
authors.initials: SE
authors.lastname: Mitchell
authors.forename: S O
authors.initials: SO
authors.lastname: Trerotola
authors.forename: M C
authors.initials: MC
authors.lastname: Wang
authors.forename: T A
authors.initials: TA
authors.lastname: Sneed
authors.forename: G B
authors.initials: GB
authors.lastname: Tudder
authors.forename: M
authors.initials: M
authors.lastname: Rosenblatt
authors.forename: G B
authors.initials: GB
authors.lastname: Lund
authors.forename: F A
authors.initials: FA
authors.lastname: Osterman
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000628:therapy; D017073:Atherectomy / Q000009:adverse effects; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000000981:diagnostic imaging; D011859:Radiography; D012008:Recurrence; D012189:Retrospective Studies; D014654:Vascular Patency