COMPARISON OF BALLOON ANGIOPLASTY AND SIMPSON ATHERECTOMY FOR LESIONSIN THE FEMOROPOPLITEAL ARTERY - ANGIOGRAPHIC AND CLINICAL-RESULTS OF A PROSPECTIVE RANDOMIZED TRIAL

PURPOSE: This study involves a prospective randomized trial comparing clinical and angiographic results of balloon angioplasty (BA) and Simp son directional atherectomy (DA) in patients with short lesions in the femoropopliteal artery causing symptoms of intermittent claudication, MATERIALS AND METHODS: Thirty-five patients were treated with BA and 38 with DA, Procedural complications were seen in eight patients. Resi dual stenoses immediately after the procedure with between 30% and 50% diameter reduction (DR) were observed in three patients after BA and in five patients after DA, In all other patients, residual stenosis wa s less than 30% DR, Two study endpoints during a a-year follow-up were used: the angiographic occurrence of restenosis with a DR of 50% or g reater or the recurrence of symptoms, RESULTS: Clinical success after 2 years, according to the criteria of the Society for Vascular Surgery /lnternational Society for Cardiovascular Surgery, was seen in 79% of the BA patients and 56% of the DA patients (P = .07), The 2-year prima ry angiographic patency rates were 67% in patients treated with BA and 44% in patients treated with DA (P = .06), The secondary angiographic ally determined patency rates were 80% and 65%, respectively (P = .15) , CONCLUSION: Simpson atherectomy is an interventional technique to tr eat arterial lesions in the femoropopliteal artery with an acceptably low complication rate, The clinical and angiographic results of DA and BA are comparable, DA should not be used to replace BA for routine tr eatment of short femoropopliteal lesions.