Abstract
To describe the use of percutaneous directional atherectomy to aid in the diagnosis of atypical Takayasu arteritis in the lower limb vessels. In a 24-year-old woman with severe peripheral artery disease (Rutherford-Becker category 5), imaging showed bilateral occlusion of the superficial femoral arteries (SFA), but no lesions of the proximal or supra-aortic vessels. The right SFA was treated first; after guidewire passage through the occlusion, 7 passes of the SilverHawk Peripheral Atherectomy Catheter debulked the lesion, followed by balloon angioplasty. Catheter biopsy showed inflammatory infiltrates consistent with Takayasu arteritis. Percutaneous transluminal atherectomy is not only an interventional device but also a diagnostic tool and can be used to distinguish between inflammatory and atherosclerotic lesions.
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