Konstantinos Stavroulakis1, Theodosios Bisdas2, Giovanni Torsello2, Arne Stachmann2, Arne Schwindt2. 1. Department of Vascular and Endovascular Surgery, University of Münster, Germany Department of Vascular Surgery, St. Franziskus-Hospital, Münster, Germany stavroulakis.konstantinos@yahoo.gr. 2. Department of Vascular and Endovascular Surgery, University of Münster, Germany Department of Vascular Surgery, St. Franziskus-Hospital, Münster, Germany.
Abstract
PURPOSE: To evaluate the midterm results of combined directional atherectomy (DA) and drug-eluting balloon (DEB) angioplasty for atherosclerotic lesions of the popliteal artery. METHODS: In a single-arm, prospective study, 21 patients (mean age 63±16 years; 16 men) with isolated popliteal artery lesions were enrolled and underwent treatment with combined DA and DEB angioplasty under filter protection between October 2009 and February 2014. The majority (18, 86%) presented with lifestyle-limiting intermittent claudication and 3 with critical limb ischemia. Fifteen (71%) target sites were de novo lesions; 4 were occlusions. The main outcome was primary patency; secondary outcomes were technical success, secondary patency, and early and midterm morbidity and mortality. RESULTS: The TurboHawk atherectomy device was used in 15 (71%) patients and the SilverHawk peripheral plaque excision system in the remaining 6 patients. The In.Pact Admiral/Pacific DEB was used in the majority of cases (15, 71%). The technical success rate was 90% (n=19). One flow-limiting dissection was treated with bailout stenting. Complications included a perforation of the popliteal artery and 2 puncture site hematomas; there was no distal embolic event. The mean follow-up was 18±12 months. Two restenoses were retreated successfully. Kaplan-Meier estimates of primary patency at 12 and 18 months were 95% and 90%, respectively; the secondary patency was 100%. One (5%) patient died in follow-up. None of the patients had an amputation. CONCLUSION: In this prospective single-arm study, the combined therapy of DA and DEB angioplasty for popliteal artery lesions showed promising midterm performance. The combination of DA and DEB may, in highly selected patients, overcome the challenges presented by the mobility of the knee joint.
PURPOSE: To evaluate the midterm results of combined directional atherectomy (DA) and drug-eluting balloon (DEB) angioplasty for atherosclerotic lesions of the popliteal artery. METHODS: In a single-arm, prospective study, 21 patients (mean age 63±16 years; 16 men) with isolated popliteal artery lesions were enrolled and underwent treatment with combined DA and DEB angioplasty under filter protection between October 2009 and February 2014. The majority (18, 86%) presented with lifestyle-limiting intermittent claudication and 3 with critical limb ischemia. Fifteen (71%) target sites were de novo lesions; 4 were occlusions. The main outcome was primary patency; secondary outcomes were technical success, secondary patency, and early and midterm morbidity and mortality. RESULTS: The TurboHawk atherectomy device was used in 15 (71%) patients and the SilverHawk peripheral plaque excision system in the remaining 6 patients. The In.Pact Admiral/Pacific DEB was used in the majority of cases (15, 71%). The technical success rate was 90% (n=19). One flow-limiting dissection was treated with bailout stenting. Complications included a perforation of the popliteal artery and 2 puncture site hematomas; there was no distal embolic event. The mean follow-up was 18±12 months. Two restenoses were retreated successfully. Kaplan-Meier estimates of primary patency at 12 and 18 months were 95% and 90%, respectively; the secondary patency was 100%. One (5%) patient died in follow-up. None of the patients had an amputation. CONCLUSION: In this prospective single-arm study, the combined therapy of DA and DEB angioplasty for popliteal artery lesions showed promising midterm performance. The combination of DA and DEB may, in highly selected patients, overcome the challenges presented by the mobility of the knee joint.
Authors: Adam J Janas; Krzysztof P Milewski; Piotr P Buszman; Wojciech Trendel; Aleksandra Kolarczyk-Haczyk; Mariusz Hochuł; Maciej Pruski; Wojciech Wojakowski; Paweł E Buszman; Radosław S Kiesz Journal: Cardiol J Date: 2018-11-05 Impact factor: 2.737
Authors: Thomas Zeller; Ralf Langhoff; Krishna J Rocha-Singh; Michael R Jaff; Erwin Blessing; Beatrice Amann-Vesti; Marek Krzanowski; Patrick Peeters; Dierk Scheinert; Giovanni Torsello; Sebastian Sixt; Gunnar Tepe Journal: Circ Cardiovasc Interv Date: 2017-09 Impact factor: 6.546
Authors: Adam Janas; Krzysztof Milewski; Piotr Buszman; Aleksandra Kolarczyk-Haczyk; Wojciech Trendel; Maciej Pruski; Wojciech Wojakowski; Paweł Buszman; Radosław S Kiesz Journal: Postepy Kardiol Interwencyjnej Date: 2020-04-03 Impact factor: 1.426
Authors: Aljoscha Rastan; James F McKinsey; Lawrence A Garcia; Krishna J Rocha-Singh; Michael R Jaff; Stuart Harlin; Suraj Kamat; Sean Janzer; Thomas Zeller Journal: J Endovasc Ther Date: 2017-11-09 Impact factor: 3.487