ABSTRACT
Recent advances in endovascular technology have generated numerous alternative procedures in the treatment of peripheral arterial occlusive disease. The application of catheter-based endovascular systems has provided a less invasive method to enhance or replace standard revascularization procedures. Mechanical atherectomy, which is based on the concept of “debulking” plaque, has been developed as an alternative to conventional percutaneous balloon angioplasty due to the limitations of PTA. Unlike PTA, which is not ideally suited for use in complex lesions (i.e., heavily calcified or intimal hyperplastic lesions), diffusely diseased vessels, and eccentric stenosis, atherectomy has a wider application to lesions not amenable to percutaneous balloon angioplasty. Atherectomy has proven to have a greater immediate success rate with less intimal dissection and occlusion; however, the long-term results are less promising. Atherectomy selectively removes atheromatous materials from diseased arteries by cutting, pulverizing, or shaving it using a mechanical catheter-deliverable endarterectomy device. Atherectomy is performed either percutaneously or through a small arteriotomy located romote from the diseased site.
