RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin · 2025
The Role of Atherectomy in the Treatment of Peripheral Artery Disease.
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Limbrock Matthias, Sunderdiek Ulrich, Haage Patrick, Stueckle Christoph Alexander
Аннотация
BACKGROUND: Peripheral arterial disease (PAD) is a prevalent and increasingly common condition associated with high morbidity and a growing number of patients worldwide. Atherectomy, a minimally invasive technique to remove or modify atherosclerotic plaques, has gained popularity as an adjunct to vessel preparation before balloon angioplasty, particularly in combination with drug-coated balloons (DCB). Its therapeutic role in PAD appears promising but requires further investigation.
MATERIALS AND METHODS: A systematic literature search was conducted in the PubMed database. Randomized controlled trials, meta-analyses, registry data, and guideline recommendations regarding atherectomy in PAD were included. The aim was to evaluate evidence on efficacy, safety, and clinical relevance across different anatomical regions and different atherectomy devices.
RESULTS AND CONCLUSION: Atherectomy shows promise as an adjunctive technique in the endovascular treatment of PAD, particularly for complex and calcified lesions in the femoropopliteal segment. While some observational and registry data suggest improved procedural success, luminal gain and reduced need for bailout stenting, randomized controlled trials yield mixed results regarding long-term patency and clinical benefit. In below-the-knee interventions, evidence remains limited and complication rates are of concern.
RESULTS AND CONCLUSION: Overall, atherectomy represents a valuable tool within a tailored treatment approach but requires further clinical validation through high-quality trials to clearly define its therapeutic role.
KEY POINTS: · Atherectomy improves vessel preparation especially in complex femoropopliteal lesions. · Randomized trials show promise but no consistent long-term benefit.. · Below-the-knee use is limited; complication rates remain relatively high.. · Device selection and operator experience are critical for procedural success.. · Atherectomy is valuable in selected cases, pending further evidence..
CITATION FORMAT: · Limbrock M, Sunderdiek U, Haage P et al. The Role of Atherectomy in the Treatment of Peripheral Artery Disease. Rofo 2025; DOI 10.1055/a-2718-7990.
MATERIALS AND METHODS: A systematic literature search was conducted in the PubMed database. Randomized controlled trials, meta-analyses, registry data, and guideline recommendations regarding atherectomy in PAD were included. The aim was to evaluate evidence on efficacy, safety, and clinical relevance across different anatomical regions and different atherectomy devices.
RESULTS AND CONCLUSION: Atherectomy shows promise as an adjunctive technique in the endovascular treatment of PAD, particularly for complex and calcified lesions in the femoropopliteal segment. While some observational and registry data suggest improved procedural success, luminal gain and reduced need for bailout stenting, randomized controlled trials yield mixed results regarding long-term patency and clinical benefit. In below-the-knee interventions, evidence remains limited and complication rates are of concern.
RESULTS AND CONCLUSION: Overall, atherectomy represents a valuable tool within a tailored treatment approach but requires further clinical validation through high-quality trials to clearly define its therapeutic role.
KEY POINTS: · Atherectomy improves vessel preparation especially in complex femoropopliteal lesions. · Randomized trials show promise but no consistent long-term benefit.. · Below-the-knee use is limited; complication rates remain relatively high.. · Device selection and operator experience are critical for procedural success.. · Atherectomy is valuable in selected cases, pending further evidence..
CITATION FORMAT: · Limbrock M, Sunderdiek U, Haage P et al. The Role of Atherectomy in the Treatment of Peripheral Artery Disease. Rofo 2025; DOI 10.1055/a-2718-7990.