Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2019 , Vol 28 , Issue 1
Directional atherectomy in femoropopliteal occlusive diseases: Our midterm results
İbrahim Yıldızhan1, Bülent Mert2, Berk Özkaynak2, Zeynep Gülben Kük2, Adil Polat2
1Department of Cardiovascular Surgery, Nevşehir State Hospital, Nevşehir, Turkey
2Department of Cardiovascular Surgery, Bağcılar Training and Research Hospital, İstanbul, Turkey
DOI : 10.9739/tjvs.2019.267 Objectives: This study aims to analyze the midterm results of directional atherectomy (DA) in patients with femoropopliteal occlusive disease.

Patients and methods: Data of a total of 21 patients (20 males, 1 female; mean age 59.7±7.9 years; range, 45 to 77 years) who underwent DA between June 2014 and December 2016 were retrospectively analyzed. The demographic data, symptomatic classifications (pre- and postoperatively), and lesion types were recorded. The pre- and postoperative patency rates were compared using computed tomography angiography and Doppler ultrasonography.

Results: Technical success and clinical improvement were obtained in all patients. One patient (4.8%) required reintervention of the target lesion and another patient (4.8%) required below-the-knee amputation during follow-up. The mean duration of amputation-free survival was 1.6±0.8 (range, 0.4 to 2.8) years. The six- and 12-month major amputation-free survival rates were 100% and 94.1%, respectively. No procedure-related mortality occurred. The mean duration of patency was 1.4±0.9 (range, 0.1-2.7) years. The mean duration of target vessel revascularization-free survival at one, two, and 2.5 years were 93.3±6.4%, 93.3±6.4%, and 62.2±25.8%, respectively. Claudication recurred in seven patients (33.3%). The mean duration of claudication-free survival was 1.4±0.9 years. Tobacco use was the only statistically significant factor for re-claudication (p=0.047).

Conclusion: Based on our midterm results, DA can be used in the first-line treatment of femoropopliteal occlusive diseases in patients with multiple comorbidities and complex lesions with a high technical success rate, a low complication rate, and favorable patency rates. Keywords : Directional atherectomy; endovascular; femoropopliteal occlusive disease