Directional Atherectomy in Peripheral Arterial Interventions

Abstract

Vessel modification is important to achieve acute procedural success in complex peripheral vascular disease, minimize dissections, and reduce the need for stenting. Removing atherosclerotic plaque as well as calcium and thrombus in the plaque, and modifying the calcium will be advantageous especially in long superficial femoral artery, popliteal artery occlusions. The Jetstream atherectomy system (Boston Scientific Corporation) is a rotating and aspirating and expandable catheter designed to remove atherosclerotic plaque and thrombus from peripheral vasculature. Phoenix atherectomy system (Volcano) is another rotational atherectomy system that continuously cuts, captures, and clears the atheroma with a low-profile catheter that can be used for below knee vessels. The Rotablator system has been used for a number of years in coronary vasculature for calcified lesions and is available for treatment of calcific disease in peripheral vasculature.