Peripheral atherectomy: a critical review.
Atherectomy is experiencing increased interest from endovascular specialists as a therapeutic treatment in the peripheral arteries. Long studied in the coronary vasculature, atherectomy has several theoretical advantages that make it uniquely suited for the peripheral circulation. In particular, infra-inguinal peripheral arterial disease experiences physiologic stresses and forces that have made traditional percutaneous coronary treatments such as angioplasty and stenting not as successful. Restenosis has been a major problem for angioplasty and stenting alone. The SilverHawk atherectomy device has favorable short-term data but important longer-term data are limited and need further study. Laser atherectomy also has favorable applications in niche patients but the number of studies is limited. Unfortunately, athero-ablative technologies for peripheral arterial disease require more definitive objective data regarding 12-month and longer-term outcomes in order to obtain widespread scientific acceptance.
Division of Cardiology and Vascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02135, USA.
Troy A
TA
Bunting
Lawrence A
LA
Garcia
D001158:Arteries / Q000473:pathology; D017073:Atherectomy / Q000295:instrumentation / Q000379:methods; D017225:Atherectomy, Coronary; D003251:Constriction, Pathologic; D004867:Equipment Design; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use; D016491:Peripheral Vascular Diseases / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D055502:Secondary Prevention; D016896:Treatment Outcome