Atherectomy with over-the-wire type catheter for femoro-popliteal artery stenosis: initial and eight month follow-up results

Percutaneous atherectomy using Atherotrack was performed in 5 patients with symptomatic femoro-popliteal artery stenosis. All patients were men and ages ranged from 37 to 70. Four lesions were atherosclerotic and 1 lesion was post-operative anastomotic stenosis following traumatic popliteal artery injury. There was no technical failure and all lesions were successfully dilated with no or minimal residual stenosis. API returned within normal limit and patients were symptom-free immediately after the procedure. We experienced no major complication related to this procedure. Excised specimen included thickened fibrous intima, atherosclerotic materials, calcification, internal elastic lamina and fibrous media. Follow-up DSA 5 months after procedure showed good patency in 4 cases, and they remained free from symptoms in this follow-up period. In those patients, lesions were generally short and eccentric, run-off was good, and only thickened intimal tissue was obtained. Those factors seem to promise long-term patency and to be good indications of atherectomy. Restenosis as well as recurrence of claudication, however, developed in one patient with DM, who had long, tight, complex stenosis and poor run-off. Considerable amount of medial tissue was found in this specimen. We suspect that those factors were associated with reduced long-term patency rates.