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 underwent
DA between June 2014 and December 2016 were retrospectively analyzed. The demographic data, symptomatic classifications (pre- and
postoperatively), and lesion types were recorded. The pre- and postoperative patency rates were compared using computed tomography
angiography and Doppler ultrasonography.
Results: Technical success and clinical improvement were obtained in all patients. One patient (4.8%) required reintervention of the target
lesion and another patient (4.8%) required below-the-knee amputation during follow-up. The mean duration of amputation-free survival
was 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. No
procedure-related mortality occurred. The mean duration of patency was 1.4±0.9 (range, 0.1-2.7) years. The mean duration of target vessel
revascularization-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 in
seven patients (33.3%). The mean duration of claudication-free survival was 1.4±0.9 years. Tobacco use was the only statistically significant
factor 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 with
multiple comorbidities and complex lesions with a high technical success rate, a low complication rate, and favorable patency rates.
Key words: Directional atherectomy; endovascular; femoropopliteal occlusive disease.
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