Two-Year Results after Directional Atherectomy of Infrapopliteal Arteries with the SilverHawk Device

Abstract

Sixteen (33%) lesions were treated after predilation; 33 (67%) lesions were treated with primary DA. All but 1 (2%) lesion could be treated with DA. In 19 (39%) lesions, additional balloon angioplasty was performed, and 2 (4%) lesions required stent implantation as a result of dissection. The mean stenosis diameter after DA was 12%+/-18% (range 0%-100%). After additional therapy, the mean stenosis diameter was 8%+/-9% (range 0%-100%). A residual stenosis </ or 30% was achieved in 48 (98%) lesions. The mean ankle-brachial index significantly increased from 0.48+/-0.26 to 0.81+/-0.32 (p<0.05) before discharge and remained improved during follow-up. Primary and secondary patency rates were 67% and 91% after 1 year and 60% and 80% after 24 months. The 12- and 24-month cumulative event-free survival rates (primary patency) by Kaplan-Meier analysis were 58%+/-8% and 46%+/-9%; at the same time intervals, the cumulative survival rates (secondary patency) were 88%+/-6% and 73%+/-9%, respectively.

Subintimal Angioplasty Is Superior to SilverHawk Atherectomy for the Treatment of Occlusive Lesions of the Lower Extremities

“…Our 38% overall assisted primary patency at 12 months was within the 22% to 64% range reported in the literature (Table 3). 10,[14][15][16][17][18] The lower patency rates in our series were likely due to more stringent TASC classification of occlusive lesions.…”

Combined HawkOne directional atherectomy and paclitaxel-coated balloon angioplasty for isolated calcified popliteal artery lesion: a no-stent approach to lower extremity endovascular revascularization

“…These events may be even more frequent in presence of severe calcifications of the target lesions. High degree of calcifications represents a real limitation for femoro-popliteal procedures in terms of immediate results due to vessel recoil after balloon angioplasty, postdilation dissection related to high pressure used, higher stent placement rate and higher stent compression and/or fractures rate (5)(6)(7). Different debulking devices have been proposed to remove calcified portion of the arterial lesions.…”

“…Different debulking devices have been proposed to remove calcified portion of the arterial lesions. Among these, DA is one of the more commonly used (7)(8)(9)(10). This helps to achieve a good angiographic success but has no effect on the restenosis rate.…”

The Role for Cryoplasty in the Treatment of Infrainguinal Artery Disease:Case Studies

“…As the treatment of in-stent restenosis is difficult and stents in the infrainguinal arteries can jeopardize the option of future bypass surgery (which conventional angioplasty without stenting generally keeps open), the concept of avoiding stent placement when possible has considerable currency among interventionists. 16 For this reason, cryoplasty and other non-stent modalities, including cutting balloon angioplasty, 32 excimer laser-assisted angioplasty, 33 and excisional 34,35 and rotational 36 atherectomy, remain attractive alternatives.…”