The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives

An ageing population and the increasing prevalence of cardiovascular risk factors have aggravated the burden of peripheral artery disease (PAD). Despite advances in the pharmacological treatment of atherosclerosis, many patients with symptomatic PAD require invasive procedures to reduce the symptoms...

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Autores principales:	Grigorios Korosoglou, Sorin Giusca, Martin Andrassy, Michael Lichtenberg
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2019
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/7a90771217de4489aa149f1296642c95
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spelling	oai:doaj.org-article:7a90771217de4489aa149f1296642c952021-12-04T16:01:12ZThe Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives10.15420/ver.2018.16.22516-33022516-3299https://doaj.org/article/7a90771217de4489aa149f1296642c952019-01-01T00:00:00Zhttps://www.verjournal.com/articles/atherectomy-peripheral-artery-diseasehttps://doaj.org/toc/2516-3299https://doaj.org/toc/2516-3302An ageing population and the increasing prevalence of cardiovascular risk factors have aggravated the burden of peripheral artery disease (PAD). Despite advances in the pharmacological treatment of atherosclerosis, many patients with symptomatic PAD require invasive procedures to reduce the symptoms of claudication, salvage tissue and prevent amputation and subsequent disability in those with critical limb ischaemia. After significant advances in endovascular treatment over the past two decades, these techniques are widely accepted as first-choice treatment in the majority of patients with PAD. However, in patients with severely calcified lesions, standard endovascular treatment such as plain or drug-coated balloon (DCB) angioplasty may fail due to vessel recoil or severe dissection in the acute setting, and intimal hyperplasia in the long term. With the use of percutaneous plaque modification and debulking techniques based on atherectomy, such calcified lesions can be tackled more easily after removal or fragmentation of atherosclerotic plaque. More homogeneous balloon expansion at lower pressures can be achieved after atherectomy, which reduces barotrauma while allowing better drug delivery to the vessel wall during DCB angioplasty avoids the need for stent placement. There are four principal methods of direct atherectomy available at the present time: directional atherectomy, rotational atherectomy, orbital atherectomy and hybrid atherectomy. In this article, we provide a short overview of these techniques and the current evidence from clinical trials to support their use.Grigorios KorosoglouSorin GiuscaMartin AndrassyMichael LichtenbergRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENVascular and Endovascular Review , Vol 2, Iss 1, Pp 12-18 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Grigorios Korosoglou Sorin Giusca Martin Andrassy Michael Lichtenberg The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives
description	An ageing population and the increasing prevalence of cardiovascular risk factors have aggravated the burden of peripheral artery disease (PAD). Despite advances in the pharmacological treatment of atherosclerosis, many patients with symptomatic PAD require invasive procedures to reduce the symptoms of claudication, salvage tissue and prevent amputation and subsequent disability in those with critical limb ischaemia. After significant advances in endovascular treatment over the past two decades, these techniques are widely accepted as first-choice treatment in the majority of patients with PAD. However, in patients with severely calcified lesions, standard endovascular treatment such as plain or drug-coated balloon (DCB) angioplasty may fail due to vessel recoil or severe dissection in the acute setting, and intimal hyperplasia in the long term. With the use of percutaneous plaque modification and debulking techniques based on atherectomy, such calcified lesions can be tackled more easily after removal or fragmentation of atherosclerotic plaque. More homogeneous balloon expansion at lower pressures can be achieved after atherectomy, which reduces barotrauma while allowing better drug delivery to the vessel wall during DCB angioplasty avoids the need for stent placement. There are four principal methods of direct atherectomy available at the present time: directional atherectomy, rotational atherectomy, orbital atherectomy and hybrid atherectomy. In this article, we provide a short overview of these techniques and the current evidence from clinical trials to support their use.
format	article
author	Grigorios Korosoglou Sorin Giusca Martin Andrassy Michael Lichtenberg
author_facet	Grigorios Korosoglou Sorin Giusca Martin Andrassy Michael Lichtenberg
author_sort	Grigorios Korosoglou
title	The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives
title_short	The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives
title_full	The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives
title_fullStr	The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives
title_full_unstemmed	The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives
title_sort	role of atherectomy in peripheral artery disease: current evidence and future perspectives
publisher	Radcliffe Medical Media
publishDate	2019
url	https://doaj.org/article/7a90771217de4489aa149f1296642c95
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The Role of Atherectomy in Peripheral Artery Disease: Current Evidence and Future Perspectives

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