Endovascular Management of the Popliteal Artery: Comparison of Atherectomy and Angioplasty

Overview

Journal Vasc Endovascular Surg

Publisher Sage Publications

Specialties Cardiology & Vascular Diseases
General Surgery

Date 2009 Nov 28

PMID 19942598

Citations 8

Authors

Elie Semaan

Naomi Hamburg

Wael Nasr

Palma Shaw

Robert Eberhardt

Jonathan Woodson

Gheorghe Doros

Denis Rybin

Alik Farber

Affiliations

Soon will be listed here.

Abstract

Purpose: Symptomatic atherosclerotic disease of the popliteal artery presents challenges for endovascular therapy. We evaluated the technical success, complications, and midterm outcomes of atherectomy and angioplasty involving the popliteal segment.

Methods: We conducted a retrospective review of outcomes of popliteal artery intervention using atherectomy or angioplasty performed between 2003 and 2008.

Results: A total of 56 patients (36% women, age 72.8 +/- 12.2 years, 77% critical limb ischemia) underwent popliteal atherectomy (n = 18) or angioplasty (n = 38). These patients had similar clinical characteristics, TransAtlantic Intersociety Consensus (TASC)/ TASC II classification, mean lesion length, and runoff scores. We observed a trend toward higher rates of technical success defined as <30% residual stenosis after atherectomy compared to angioplasty (94% vs 71%, P = .08). While angioplasty was associated with a higher frequency of arterial dissection (23% vs 0%, P = .003), atherectomy was associated with a higher rate of thromboembolic events (22% vs 0%, P = 0.01). Adjunctive stenting was used more frequently following angioplasty compared to atherectomy (45% vs 6%, P = .005). Thrombolysis was used to treat embolization in 4 patients in the atherectomy group. The improvement in the ankle-brachial index (ABI) was similar between the 2 treatment groups. Primary patency of the popliteal artery at 3, 6, and 12 months was 94%, 88%, and 75% in the atherectomy group and 89%, 82%, and 73% in the angioplasty group (P = not significant [NS]). There were no significant differences in limb salvage and freedom from reintervention at 1 year between the atherectomy and angioplasty groups.

Conclusions: Our experience with popliteal artery endovascular therapy indicates a distinct pattern of procedural complications with atherectomy compared to angioplasty but similar midterm patency, limb salvage, and freedom from intervention.

Citing Articles

Treatment extent of femoropopliteal disease and clinical outcomes following endovascular therapy.

Yoon Y, Lee J, Hwang W, Park H, Roh J, Lee S EuroIntervention. 2024; 20(18):e1154-e1162.

PMID: 39279516 PMC: 11384224. DOI: 10.4244/EIJ-D-24-00037.

Intravascular Lithotripsy in Calcified Peripheral Lesions: Single-Center JEN-Experience.

Aftanski P, Thieme M, Klein F, Schulze P, Mobius-Winkler S, Kretzschmar D Int J Angiol. 2023; 32(1):11-20.

PMID: 36727147 PMC: 9886450. DOI: 10.1055/s-0042-1751229.

The role of directional atherectomy in critical-limb ischemia.

Krishnan P, Tarricone A, Chen S, Sharma S Ther Adv Cardiovasc Dis. 2021; 135:17539447211046953.

PMID: 34796770 PMC: 8606915. DOI: 10.1177/17539447211046953.

An Endovascular Strategy for Occlusion or Stenosis with Severe Calcification in the Non-Stenting Zone, creatinG Lumens And SlitS with Crosser in Unique Technique (GLASS CUT): A Case Report.

Maruyama T, Miyamoto A Ann Vasc Dis. 2018; 10(4):426-429.

PMID: 29515708 PMC: 5835425. DOI: 10.3400/avd.cr.17-00041.

One-Year Outcomes Following Directional Atherectomy of Popliteal Artery Lesions: Subgroup Analysis of the Prospective, Multicenter DEFINITIVE LE Trial.

Rastan A, McKinsey J, Garcia L, Rocha-Singh K, Jaff M, Harlin S J Endovasc Ther. 2017; 25(1):100-108.

PMID: 29117818 PMC: 5774616. DOI: 10.1177/1526602817740133.

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