Speaker: Sheng Wang, MD
Hospital: Beijing Anzhen Hospital, Capital Medical University
Abstract
Vessel preparation is critical in lower extremity arterial interventions. This article analyzes the clinical scenarios for directional atherectomy (e.g., TurboHawk™) versus Chocolate PTA, emphasizing their roles in calcified, occlusive, and femoral-popliteal lesions. Case studies and imaging data illustrate optimized strategies for different lesion types.
Introduction
Complex arterial lesions demand tailored preparation. Directional atherectomy excels in heavily calcified or long occlusions, while Chocolate balloons minimize vessel trauma in short occlusions or popliteal/BTK lesions. This work compares technical nuances and indications through real-world cases.
Case Studies
Severely Calcified SFA Lesion
Features: Long-segment, circumferential calcification.
Procedure: Pre-dilation + TurboHawk™ debulking followed by DCB.
Outcome: No flow-limiting dissection, avoiding stent implantation.
Popliteal Short Occlusion
Features: Moderate calcification, length <15 cm.
Procedure: Chocolate balloon (4×150 mm) dilation with <30% residual stenosis.
Complication: Proximal dissection without hemodynamic impact.
Conclusion
1.Directional Atherectomy: Preferred for heavy calcification, long occlusions, or common femoral lesions.
2.Chocolate PTA: Ideal for short occlusions, popliteal/BTK lesions, or time-sensitive cases.
3.Combined Approach: Debulking + DCB may optimize outcomes in long calcified lesions but requires careful dissection monitoring.