title: Mechanical recanalization of subacute vessel occlusion in peripheral arterial disease with a directional atherectomy catheter.
abstract: OBJECTIVE
  To retrospectively examine the technical feasibility and safety of directional atherectomy for treatment of subacute infrainguinal arterial vessel occlusions.
  
  
  METHODS
  Five patients (one woman, four men, age range 51-81 years) with peripheral arterial disease who experienced sudden worsening of their peripheral arterial disease-related symptoms during the last 2-6 weeks underwent digital subtraction angiography, which revealed vessel occlusion in native popliteal artery (n = 4) and in-stent occlusion of the superficial femoral artery (n = 1). Subsequently, all patients were treated by atherectomy with the SilverHawk (ev3 Endovascular, USA) device.
  
  
  RESULTS
  The mean diameter of treated vessels was 5.1 ± 1.0 mm. The length of the occlusion ranged 2-14 cm. The primary technical success rate was 100%. One patient experienced a reocclusion during hospitalization due to heparin-induced thrombocytopenia. There were no further periprocedural complications, in particular no peripheral embolizations, until hospital discharge or during the follow-up period of 1 year.
  
  
  CONCLUSIONS
  The recanalization of infrainguinal arterial vessel occlusions by atherectomy with the SilverHawk device is technically feasible and safe. In our limited retrospective study, it was associated with a high technical success rate and a low procedure-related complication rate.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Saarland University Hospital, Homburg/Saar, Germany. Alexander.Massmann@uks.eu
authors.forename: Alexander
authors.initials: A
authors.lastname: Massmann
authors.forename: Marcus
authors.initials: M
authors.lastname: Katoh
authors.forename: Roushanak
authors.initials: R
authors.lastname: Shayesteh-Kheslat
authors.forename: Arno
authors.initials: A
authors.lastname: Buecker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D017073:Atherectomy / Q000295:instrumentation*; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D011150:Popliteal Artery; D012189:Retrospective Studies; D016896:Treatment Outcome