ANGIOGRAPHIC FOLLOW-UP AND CLINICAL OUTCOME OF 126 PATIENTS AFTER PERCUTANEOUS DIRECTIONAL ATHERECTOMY (SIMPSON ATHEROCATH) FOR OCCLUSIVE PERIPHERAL VASCULAR-DISEASE

Angiographic and clinical follow-up data were obtained in 115/126 patients who underwent directional atherectomy for peripheral vascular disease; of the 126, ten were excluded for appropriate reasons and one was lost to follow-up. Thus, 115/116 successful atherectomy patients (99%) had follow-up of 182/213 lesions (86%): 74 patients (64%) with angiography (mean time 5.4 mon), and 41 patients (36%) clinically. One hundred twenty-eight of 183 lesions (70%) had angiographic follow-up; the lesion recurrence as a stenosis or as an occlusion was 53%. Lesion distribution did not differ between angiography and clinical follow-up groups: nearly 85% were within the superficial femoral or popliteal arteries. Despite data stratification, angiographic follow-up indicated that patients after successful directional atherectomy, at a mean follow-up time of > 5 mos, have more than a 50% lesion recurrence rate. Although directional atherectomy (Simpson AtheroCath(TM)) utilizing present techniques has excellent primary success and acceptable complication rates, angiographic follow-up statistics are bothersome.