வாஸ்குலர் மெடிசின் & அறுவை சிகிச்சை இதழ்

சுருக்கம்

RAVS Study: A Single Center Experience with Turbo hawk Directional Atherectomy Device to analyze it as an Emerging Modality for Treatment of Long Segment Femoro-Popliteal Occlusive Disease

Chandrashekar Anagavalli Ramswamy, Vivek Vardhan Jayaprakash*, Adharsh Kumar Maruthu Pandian, Sanjay C Desai, Rajendra Prasad Basavanthappa, Ashwini Naveen Gangadharan, Ranjith Kumar Anandasu, Nivedita Mitta, Hemanth Kumar Choudary

Background: Despite advances to prevent and better manage patients with established Peripheral Arterial Disease (PAD), the incidence of PAD continues to increase and morbidity remains high, especially as the population ages. For physicians treating PAD cases, an understanding of the various treatment options, along with their benefits and limitations is crucial. Endovascular treatment with Turbo hawk atherectomy device has promising technical and clinical success rates.

Objective: To consider Turbo hawk directional atherectomy as an important and safer endovascular modality for treatment of long segment Femoro-popliteal occlusive disease.

Methods: This is a retrospective study which included 40 patients diagnosed with PAD (long segment occlusion of Femoro-popliteal arteries), who came to Ramaiah medical college hospital, Bangalore from June 2014 to June 2018 and fit into specified inclusion criteria with mean age of the patients being 61.5 years. All these patients underwent endovascular therapy with turbo hawk atherectomy device and post intervention was followed for a period of one year.

Results: Primary technical success rate was 97%. Pre-operatively mean ABI was 0.27 and post–operative mean ABI was 0.64. An average length of corrected lesion was 10.5cms. Post-operatively one patient had an episode of distal embolization, two patients had dissection and three had puncture site hematomas, all of which were managed conservatively. No vessel perforation was observed in our study. Patients were followed up at 1 month, 6 months and 12 months postoperatively. Primary vessel patency rates at 6 and 12 -months were 96% and 85%.

Conclusion: Directional atherectomy using turbo hawk device is safe, effective at 12 months for medium and long segment femoro-popliteal lesions in claudicants as well as in patients with critical limb threatening ischemia and has a primary patency rates of 85 % over 1-year period. Further, complication rates that warrants a treatment is also very low with Turbo hawk as seen with our study.