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Duplex Surveillance after Primary Balloon Angioplasty or Directional Atherectomy for Treating Infrainguinal Arterial Disease
J Surg Ultrasound 2019;6:46-52
Published online November 30, 2019
© 2019 The Korean Surgical Ultrasound Society

Kyung Pyo Hong, Sungsin Cho, Jin Hyun Joh

Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
Received October 5, 2019; Revised November 18, 2019; Accepted November 26, 2019.
Journal of Surgical Ultrasound is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: Percutaneous transluminal angioplasty (PTA) shows an attractive outcome for treating infrainguinal arterial occlusive disease (IAOD). However, this procedure requires repeated revascularization and additional stenting. Directional atherectomy (DA) has been reported to be a modality that requires less frequent use of stenting. The aim of this study was to compare the duplex-based outcomes between PTA and DA for treating IAOD.
Methods: A retrospective review of consecutive patients with IAOD treated with PTA and DA was completed. The demographics and procedural data were obtained. A provisional stent was placed in those cases with flow-limiting dissection and residual stenosis after PTA or DA. Technical success was defined as a residual stenosis < 30%. The primary patency rate was evaluated by performing duplex scanning. The clinical outcomes and frequency of stent placement for each procedure were evaluated. For statistical analysis, the data was analyzed using SPSS 22.0 software (IBM Corp, Chicago, Ill). All P values were considered significant if less than 0.05.
Results: Seventy-one patients were included in the study. Their mean age was 71.5 ± 10.2 years. The male-to-female ratio was 49:22. Thirty-three patients underwent PTA. DA was performed in 38 patients (42 limbs). Technical success was achieved in all the patients. The duplex-based clinical outcome and limb salvage rate were similar in the two groups. Bailout stent placement was performed in 8 of 33 patients (24.2%) in the PTA group and in no patient in the DA group.
Conclusion: The clinical outcomes were similar for both the DA and primary PTA groups. Atherectomy reduced the need for bailout stent placement as compared with bailout stent placement in primary PTA.
Keywords : Jin Hyun Joh
Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
Tel: +82-2-440-6261
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November 2019, 6 (2)