The “Nonsurgical” Treatment of Iliofemoral Arteriosclerotic Obstruction

Dotter, Charles T.; Frische, Louis H.; Judkins, Melvin P.; Mueller, Robert

doi:10.1148/86.5.871

Cited by 23 publications

(2 citation statements)

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“…Endovascular treatment has evolved from Charles Dotter's use of coaxial “pencil-point” dilators to treat superficial femoral artery (SFA) stenosis in 1964 [1]. Revascularization via endovascular treatment is widely used in the cardiovascular field.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of intraopertive ultrasonography during directional atherectomy using SilverHawk/TurboHawk system

et al. 2017

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PurposeDirectional atherectomy (DA) was introduced for the management of infrainguinal arterial stenosis or occlusive lesions. The procedure success rate in the DEFINITIVE LE study was determined using radiologic imaging. The aim of our study was to determine the usefulness of intraoperative ultrasonography (USG) during DA for evaluating the early results of this procedure.MethodsPatients who underwent DA from January to December 2014 were reviewed retrospectively. Twenty lesions from 14 patients with femoral artery stenosis (>70% stenosis) with short segment occlusive lesions (<2 cm in length) were treated. Among 20 lesions, 3 were treated with the TurboHawk system with a protective device due to lesion calcification. The percentage of stenosis during and after DA was determined with USG.ResultsMedian follow-up was 5.1 months, and the procedural success rate (<30% stenosis at the end of the procedure) was 100% on angiography, but only 30% on intraoperative USG. On USG, median residual stenosis was 40% (range, 28%–42%) at the end of DA, 40% (range, 30%–55%) at 1 month, 55% (range, 35%–85%) at 6 months, and 64% (range, 60%–100%) at 1 year. There was one dissection, but no cases of perforation, pseudoaneurysm, or thrombosis. Primary patency, which was defined as a peak systolic velocity ratio ≤3.5 with no reintervention at 6 months, was found in 18 lesions (90%), and 11 of 14 patients (78.6%) were free of ischemic symptoms such as claudication at 6 months.ConclusionOur results demonstrated that DA with intraoperative USG is an effective treatment option for short segment occlusive lesions of the femoral artery.

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Section: Introductionmentioning

confidence: 99%

Usefulness of intraopertive ultrasonography during directional atherectomy using SilverHawk/TurboHawk system

et al. 2017

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“…Over the past decade, endovascular intervention of the femoropopliteal artery has become the preferred initial therapy for lifestyle‐limiting claudication when compared to a surgical approach , though no single endovascular first‐line therapy has emerged. This evolution of femoropopliteal artery treatment has resulted in multiple endovascular modalities, including percutaneous transluminal angioplasty , drug‐coated balloon angioplasty , atherectomy , bare‐metal stent , drug‐eluting stent , and fabric‐covered stent‐graft . Despite these therapeutic advancements, restenosis remains the major limitation associated with all treatment modalities regardless of device technology .…”

Section: Introductionmentioning

confidence: 99%