How to Deal with Infrainguinal Arterial Calcifications: Atherectomy and Lithoplasty Devices

Dierk Vorwerk

doi:10.4103/AJIR.AJIR_12_20

The Arab Journal of Interventional Radiology, Table of Contents

CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2020; 4(02): 060-066
DOI: 10.4103/AJIR.AJIR_12_20

Review Article

How to Deal with Infrainguinal Arterial Calcifications: Atherectomy and Lithoplasty Devices

Dierk Vorwerk

Department of Radiology, Klinikum Ingolstadt, Ingolstadt, Germany

› Author Affiliations

Abstract

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This overview article should describe current technical problems of severe infrainguinal calcifications, outline solutions for challenging and complex lesions and give an overview over currently available debulking devices which are meant to deal with calcified lesions. As a relatively new device, arterial lithoplasty is discussed.

infrainguinal calcifications - atherectomy - lithoplasty

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References

References
1 Dippel EJ, Makam P, Kovach R, George JC, Patlola R, Metzger DC, et al. Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: Initial results from the EXCITE ISR trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis). JACC Cardiovasc Interv 2015;8:92-101.
2 Zeller T, Langhoff R, Rocha-Singh KJ, et al. Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency: Twelve-Month Results of the DEFINITIVE AR Study. Circ Cardiovasc Interv 2017;10: pii: e004848. doi: 10.1161/CIRCINTERVENTIONS.116.004848.
3 Ambler GK, Radwan R, Hayes PD, Twine CP. Atherectomy for peripheral arterial disease. Cochrane Database Syst Rev 2014;17:CD006680. doi: 10.1002/14651858.CD006680.pub2.
4 Shammas NW, Lam R, Mustapha J, Ellichman J, Aggarwala G, Rivera E, et al. Comparison of orbital atherectomy plus balloon angioplasty vs. balloon angioplasty alone in patients with critical limb ischemia: Results of the CALCIUM 360 randomized pilot trial. J Endovasc Ther 2012;19:480-8.
5 Dattilo R, Himmelstein SI, Cuff RF. The COMPLIANCE 360° Trial: A randomized, prospective, multicenter, pilot study comparing acute and long-term results of orbital atherectomy to balloon angioplasty for calcified femoropopliteal disease. J Invasive Cardiol 2014;26:355-60.
6 Shammas N, Shammas G, Banerjee S, Popma JJ, Mohammad A, Jerin M. Jet stream rotational and aspiration atherectomy in treating in-stent restenosis of the femoropopliteal arteries: Results of the JETSTREAM-ISR feasibility study. J Endovasc Ther 2016;23:339-46.
7 Gray W, Garcia L, Amin A, Shammas NW; JET Registry Investigators. Jet stream atherectomy system treatment of femoropopliteal arteries: Results of the post-market JET Registry. Cardiovasc Revasc Med 2018:19:506-11.
8 Reeves R, Imsais JK, Prasad A. Successful management of lower extremity distal embolization following percutaneous atherectomy with the Jet stream G3 device. J Invasive Cardiol 2012;24:E124-8.
9 Maehara A, Mintz GS, Shimshak TM, Ricotta JJ 2nd, Ramaiah V, Foster MT 3rd, et al. Intravascular ultrasound evaluation of JETSTREAM atherectomy removal of superficial calcium in peripheral arteries. EuroIntervention 2015;11:96-103.
10 Gandini R, Pratesi G, Merolla S, et al. Single Center Experience With Phoenix Atherectomy System in Patients With Moderate-Heavily Calcified Femoropopliteal Lesions Cardiovasc Revasc Med 2019;23:pii: S1553-8389(19)30492-0. doi: 10.1016/j.carrev.2019.08.019. [Epub ahead of print].
11 Brodmann M, Holden A, Zeller T. Safety and feasibility of intravascular lithotripsy for treatment of below-the-knee arterial stenoses. J Endovasc Ther 2018;25:499-503.
12 Brodmann M, Werner M, Holden A, Tepe G, Scheinert D, Schwindt A, et al. Primary outcomes and mechanism of action of intravascular lithotripsy in calcified, femoropopliteal lesions: Results of disrupt PAD II. Catheter Cardiovasc Interv 2019;93:335-42.