Abstract：
Background: This study aimed to assess the peri- and postprocedural outcomes of atherectomy-assisted endovascular treatment of the common femoral (CFA) and popliteal arteries. Methods: Phoenix atherectomy was used for the treatment of 73 and 53 de novo CFA and popliteal artery lesions, respectively, in 122 consecutive patients. Safety endpoints encompassed perforation and peripheral embolization. Postprocedural endpoints included freedom from clinically driven target lesion revascularization (CD-TLR) and clinical success (an improvement of ⩾ 2 Rutherford category [RC]). In addition, 531 patients treated for popliteal artery stenosis or occlusion without atherectomy were used as a comparator group. Results: Procedural success (residual stenosis < 30% after treatment) was 99.2%. The need for bail-out stenting was 2 (2.7%) and 3 (5.7%) in CFA and popliteal artery lesions, respectively. Only one (1.4%) embolization occurred in the CFA, which was treated by catheter aspiration. No perforations occurred. After 1.50 (IQR = 1.17-2.20) years, CD-TLR occurred in seven (9.2%) and six (14.6%) patients with CFA and popliteal artery lesions, respectively, whereas clinical success was achieved in 62 (91.2%) and 31 (75.6%), respectively. Patients treated with atherectomy and DCB in the popliteal artery after matching for baseline RC, lesion calcification, length, and the presence of chronic total occlusion, exhibited higher freedom from CD-TLR compared to the nondebulking group (HR = 3.1; 95% CI = 1.1-8.5, p = 0.03). Conclusion: Atherectomy can be used safely and is associated with low rates of bail-out stenting in CFA and popliteal arteries. CD-TLR and clinical success rates are clinically acceptable. In addition, for the popliteal artery, atherectomy combined with DCB demonstrates lower CD-TLR rates compared to a DCB alone strategy. (German Clinical Trials Register: DRKS00016708).
摘要：
背景：本研究旨在评估动脉粥样硬化切除术辅助腔内治疗股动脉（CFA）和the动脉的围手术期和术后结果。方法:采用凤凰动脉粥样硬化切除术治疗73例和53例新生CFA及pop动脉病变,分别,连续122例患者。安全性终点包括穿孔和周围栓塞。术后终点包括无临床驱动的靶病变血运重建（CD-TLR）和临床成功（2卢瑟福类别[RC]的改进）。此外,531例患者接受了the动脉狭窄或闭塞而没有动脉粥样硬化切除术作为比较组。结果：手术成功率（治疗后残余狭窄<30％）为99.2％。在CFA和pop动脉病变中，需要进行纾困支架置入2（2.7％）和3（5.7％），分别。CFA中仅发生1例（1.4%）栓塞，通过导管抽吸治疗。没有发生穿孔。在1.50(IQR=1.17-2.20)年之后，CD-TLR发生在7例（9.2％）和6例（14.6％）CFA和the动脉病变患者中，分别,而临床成功率分别为62例(91.2%)和31例(75.6%)，分别。与基线RC匹配后，在pop动脉中接受斑块切除术和DCB治疗的患者，病变钙化,长度,以及慢性完全闭塞的存在，与非减积组相比,CD-TLR的自由度更高(HR=3.1;95%CI=1.1-8.5,p=0.03).结论：动脉粥样硬化切除术可以安全使用，并且在CFA和pop动脉中的支架置入率较低。CD-TLR和临床成功率是临床上可接受的。此外,对于the动脉，与单独使用DCB策略相比,斑块切除术联合DCB显示出更低的CD-TLR率.（德国临床试验注册：DRKS00016708）。
