Experience with Directional Atherectomy in Infrainguinal Peripheral Arterial Disease with Using a Silverhawk Plaque Excision Device
Journal of the Korean Society for Vascular Surgery
;
: 47-52, 2009.
Article
Dans Coréen
| WPRIM
| ID: wpr-161862
ABSTRACT
PURPOSE:
This study was conducted to report our single center experience with performing directional atherectomy in patients with infra-inguinal arterial disease by using the Silverhawk plaque excision device. This procedure was performed at Washington University Hospital in St. Louis, USA (WASH).METHODS:
Fifty-six patients with 102 lesions and who were classified into the Rutherford categories 2 to 6 underwent 66 procedures using the Silverhawk device from November 2004 to July 2007 in WASH. The patients' medical records were retrospectively reviewed.RESULTS:
The initial technical success rate was 86.4%. The primary patency rate and limb salvage rate at 1 year was 48.5% and 80.3%, respectively. After 2 year' s follow-up, there was no occlusion or limb loss, and the overall primary patency rate and limb salvage was 45.5% and 75.8%, respectively. The mean preoperative ABI was 0.52+/-0.24 and the postoperative ABI was 0.73+/-0.22 (P=0.001). The one-year primary patency rate in the TASC II A and B group was 56.4% and that in the C and D group was 29.6% (P=0.003, P=0.007), respectively. There was a significantly different between both groups. However, the location, nature and length of the lesion, the Rutherford category and the adjunctive procedures did not statistically affect the primary patency rate.CONCLUSION:
In this study, the Silverhawk plaque excision device was a feasible treatment modality for infra-inguinal peripheral arterial disease because of its high technical success rate, the primary patency rate and the limb salvage rate. However, it had an obstacle for being accepted for widespread use because secondary endovascular techniques are frequently required for restenosis after plaque excision. The practical use of the Silverhawk is controversial and further studies will be needed.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Washington
/
Dossiers médicaux
/
Études rétrospectives
/
Études de suivi
/
Athérectomie
/
Sauvetage de membre
/
Membres
/
Maladie artérielle périphérique
/
Procédures endovasculaires
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Humains
Pays comme sujet:
Amérique du Nord
langue:
Coréen
Texte intégral:
Journal of the Korean Society for Vascular Surgery
Année:
2009
Type:
Article
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