Abstract：
Objective: This study aims to elucidate the differences in vessel patency rates, procedural complications, and the need for repeat interventions between these two techniques, thereby providing insights into the optimal atherectomy strategy for managing peripheral arterial disease in the femoropopliteal segment. Material and Methods: This retrospective study investigated the long-term effectiveness of two atherectomy techniques, rotational atherectomy (RA) and directional atherectomy (DA), in treating lower extremity peripheral artery disease (LE-PAD) affecting the superficial femoral artery (SFA) and popliteal arteries. A total of 134 patients with symptomatic LE-PAD and significant stenosis (70%-99%) were included and divided into two groups based on the atherectomy method used. Both groups underwent similar pre- and post-atherectomy procedures, including drug-coated balloon angioplasty. The primary outcome measure was clinical success, defined as procedural success and an improvement in Rutherford classification at 1 year. Results: Baseline characteristics were similar between the two groups, with no significant differences in demographics or lesion characteristics, except for a higher proportion of right-sided lesions in the DA group. While both RA and DA effectively improved ankle-brachial index (ABI) and Rutherford classification at 12 months, RA demonstrated superior long-term benefits, with significantly higher ABI at 24 months and a greater proportion of asymptomatic patients. Although RA had a longer procedural duration and a higher incidence of dissection, it resulted in lower residual stenosis and fewer cases of treated segment thrombosis than DA. Both RA and DA are effective treatment options for femoropopliteal lesions, but RA may offer advantages in long-term symptom management and vessel patency. Conclusion: Both rotational and directional atherectomy effectively treat femoropopliteal lesions, with rotational atherectomy demonstrating superior long-term outcomes in terms of symptom management and vessel patency. Despite longer procedural times and a slightly higher risk of dissection, rotational atherectomy resulted in lower residual stenosis and fewer cases of treated segment thrombosis than directional atherectomy.
摘要：
目的：本研究旨在阐明血管通畅率的差异，手术并发症,这两种技术之间需要重复干预，从而提供最佳的动脉粥样硬化切除术策略的见解，以管理股pop段周围动脉疾病。材料和方法：这项回顾性研究调查了两种斑块切除技术的长期有效性，旋磨（RA）和定向旋磨（DA），用于治疗影响股浅动脉（SFA）和the动脉的下肢外周动脉疾病（LE-PAD）。总共纳入134例有症状的LE-PAD和明显狭窄（70％-99％）的患者，并根据所使用的斑块切除术方法分为两组。两组都接受了相似的动脉粥样斑块切除术前和后手术，包括药物涂层球囊血管成形术。主要结果指标是临床成功，定义为程序上的成功和卢瑟福分类在1年的改进。结果:两组基线特征相似,人口统计学或病变特征无显著差异，除了DA组中右侧病变的比例较高。虽然RA和DA在12个月时有效改善了踝肱指数（ABI）和卢瑟福分类，RA表现出优越的长期益处，24个月时ABI显著升高，无症状患者比例更高。尽管RA的手术持续时间较长，夹层发生率较高，与DA相比，它导致较低的残余狭窄和较少的治疗节段血栓形成病例。RA和DA都是股pop病变的有效治疗选择，但RA在长期症状管理和血管通畅方面可能具有优势.结论:旋磨和定向旋磨两种方法均能有效治疗股pop病变。旋磨术在症状处理和血管通畅方面显示出优越的长期结局。尽管手术时间较长，解剖风险略高，与定向粥样斑块切除术相比，旋转粥样斑块切除术的残余狭窄较低，治疗节段血栓形成的病例较少。
