INFRAINGUINAL DIRECTIONAL ATHERECTOMY - LONG-TERM FOLLOW-UP AND COMPARISON WITH PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

Purpose: To assess the long-term results of directional atherectomy (D A) for femoropopliteal artery atherosclerotic lesions and to compare t he results to those previously reported for percutaneous transluminal balloon angioplasty (PTA). Materials and Methods: Eighty-four percutan eous DA procedures performed on 75 patients between July 1988 and Augu st 1992 were retrospectively reviewed and evaluated for technical and initial clinical success. Long-term patency was assessed with a combin ation of ankle-brachial index measurements and angiography. Results: I nitial technical success was achieved in 77 of 84 procedures (92%). Fo llow-up of 72 patients was obtained, including 74 of the 84 (88%) DA p rocedures with a mean follow-up of 17.4 months (range 1-48 months). Pr imary patency was 78% at 1 year and 57% at 2 years. Patients with diab etes, complete luminal occlusion, or limb salvage situations had signi ficantly lower patency. Conclusions: Femoropopliteal artery DA can be performed safely with a high technical and initial clinical success. L ong-term patency is improved when compared with published series for P TA. With this improvement in mind, DA may have a place in the treatmen t of focal infrainguinal stenoses.