Percutaneous removal of atheromatous plaques in peripheral arteries.

The peripheral Simpson "atherectomy" catheter was used to treat 21 patients with a total of 41 stenotic lesions (5 iliac, 35 superficial femoral, and 1 popliteal). 4 lesions were totally occluded and 16 (39%) were calcified. The mean (SD) degree of obstruction was reduced from 82.7 (14) to 21 (16)% (p less than 0.0001). Mean (SD) standardised walking distance increased from 79.9 (71.9) to 152.6 (89.7) m (p less than 0.0001); doppler index improved from 0.58 (SD 0.17) to 0.81 (0.16) (p less than 0.0001); performance on bicycle stress test rose from 276.3 (range 1-1100) to 584.8 (2-2250) watt-min; and index for 201Tl-scintigraphy of the lower leg increased from 0.68 (0.28) to 0.91 (0.36) (p less than 0.02). The improvement has been maintained for 6 months, the degree of stenosis on repeat angiography at 2-6 months (n = 14 lesions) being 20.7 (SD 13.7)% (unchanged from early post-treatment values). The only restenosis has been corrected by a repeat of the percutaneous procedure.