Directional atherectomy in femoropopliteal occlusive diseases: Our midterm results

Özet

Objectives: This study aims to analyze the midterm results of directional atherectomy (DA) in patients with femoropopliteal occlusive disease.Patients and methods: Data of a total of 21 patients (20 males, 1 female; mean age 59.7±7.9 years; range, 45 to 77 years) who underwentDA between June 2014 and December 2016 were retrospectively analyzed. The demographic data, symptomatic classifications (pre- andpostoperatively), and lesion types were recorded. The pre- and postoperative patency rates were compared using computed tomographyangiography and Doppler ultrasonography.Results: Technical success and clinical improvement were obtained in all patients. One patient (4.8%) required reintervention of the targetlesion and another patient (4.8%) required below-the-knee amputation during follow-up. The mean duration of amputation-free survivalwas 1.6±0.8 (range, 0.4 to 2.8) years. The six- and 12-month major amputation-free survival rates were 100% and 94.1%, respectively. Noprocedure-related mortality occurred. The mean duration of patency was 1.4±0.9 (range, 0.1-2.7) years. The mean duration of target vesselrevascularization-free survival at one, two, and 2.5 years were 93.3±6.4%, 93.3±6.4%, and 62.2±25.8%, respectively. Claudication recurred inseven patients (33.3%). The mean duration of claudication-free survival was 1.4±0.9 years. Tobacco use was the only statistically significantfactor for re-claudication (p=0.047).Conclusion: Based on our midterm results, DA can be used in the first-line treatment of femoropopliteal occlusive diseases in patients withmultiple comorbidities and complex lesions with a high technical success rate, a low complication rate, and favorable patency rates.