Rotational Atherectomy with Drug-eluting Balloon Angioplasty for Femoropopliteal Artery Occlusive Disease: Serial Case
DOI:
https://doi.org/10.35790/msj.v8i1.64431Keywords:
rotational atherectomy; drug-eluting balloon angioplasty; artery occlusive diseaseAbstract
Abstract: Peripheral artery disease (PAD) leads to symptoms ranging from claudication to chronic limb threatening ischemia (CLTI), and is linked to aging, diabetes, hypertension, and smoking. While conventional treatments such as balloon angioplasty and stenting are effective for short lesions, they struggle with complex or calcified lesions. Rotational atherectomy has emerged as a promising solution, particularly for calcified lesions in the superficial femoral and popliteal arteries. This case series highlights the success of rotational atherectomy in treating PAD patients with non-healing ulcers, improving limb perfusion and healing, and offering a minimally invasive alternative to amputation. First case was an 80-year-old male with severe PAD and CTO of the left SFA and CFA, treated successfully with endovascular revascularization using atherectomy and drug-eluting balloon angioplasty. Second case was a 50-year-old diabetic male with gangrene and rest pain in the third toe, caused by a heavily calcified CTO in the mid-SFA. Endovascular revascularization using rotational atherectomy followed by drug-eluting balloon angioplasty were performed. Third case was a 63-year-old female with diabetes, hypertension, and chronic kidney disease, who presented with gangrene and rest pain in her right foot due to complex PAD with CTO. Endovascular revascularization using rotational atherectomy and drug-eluting balloon angioplasty was successfully performed. The outcomes showed successfully restored blood flow, alleviated symptoms, and improved limb perfusion, demonstrating the efficacy of these techniques in high-risk PAD patients. In conclusion, rotational atherectomy followed by drug-eluting balloon angioplasty effectively revascularized complex, calcified lesions in CLTI patients, offering a promising, minimally invasive alternative to surgery, though further studies are needed to confirm long-term benefits. Future studies should compare the long-term patency and major adverse events between this method and traditional balloon angioplasty alone.
Keywords: rotational atherectomy; drug-eluting balloon angioplasty; artery occlusive disease
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