Role of Atherectomy Devices in the Treatment of Lower Extremity Peripheral Arterial Disease (original) (raw)
Atherosclerosis is a systemic disease affecting all major vascular beds. Risk factors for atherosclerosis, and therefore, for PAD, include active smoking, advance age, dyslipidemia, diabetes mellitus, and hypertension. Due to continuous increase in aging population and diabetes, incidence of peripheral arterial disease will continue to increase. While atherosclerotic coronary disease usually have focal lesions and can successfully be treated with balloon angioplasty or stent. Lower extremity peripheral arterial occlusive disease however, poses a unique challenge to traditional angioplasty-based endovascular therapies. The diffuse nature of lower extremity atherosclerotic disease, the presence of chronic total occlusions, poor distal runoff, and the presence of critical limb ischemia all have contributed to the disappointing results of balloon angioplasty for complex infrainguinal arterial disease. This results in development of a host of new technologies such drug eluting balloon and atherectomy in an attempt to improve the safety and effectiveness of percutaneous revascularization for lower extremity peripheral arterial occlusive disease. This review summarizes the available atherectomy devices their mechanism of action and literature supporting their use.
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