Newer Atherectomy devices for the SFA occlusion


Atheroscleorotic lesions in the lower limbs usually present in the late stages. TASC D lesions with poor distal run off is not uncommon in our clincal practice. When such patients are seen with gangrenous changes in the toes we have to attempt some kind of recanlaization treatements. Placement of stent or stent graft is going to be very difficult and at the same time a long segment has to be covered with 3 or more number of stents. Excimer Laser and other type of measures have not proved good enough. In the recent past we have performed Atherectomy using the silver hawk atherectomy device from the tibial artery, popliteal artery and femoral artery. Multiple long small pieces of atheroma was removed to obtain a decent lumen in the vessels from the groin up to the knee. Post precedure tha ankle pressure was 110 mm of Hg and maintained so till now that is 10 months.

This device is superior version of atherectomy devices. There different sizes to match the size of the artery that needs debulking. The chances of rupture are rare and easily that stop with compression bandages. Distal protection device was used in this patient ( spider XX) to extract distlly embolized material. There was some amount of debris after the completion of the precure in the spider X filter device. In such type of complex procedures one should be considering a protection device to avoid the complications.

This device is getting popular in certain but not yet approved in many centers for the routine clinical usuage.

Lecture given by
Prof.Pinjala R K’08
1 Nov 2008
ISVIR, Mumbai , J W Marriot Hotel.