Analysis of Clinical Outcomes Following Directional Atherectomy in Superficial Femoral Artery Chronic Long-Segment Occlusions Causing Chronic Limb Ischemia: A Tertiary-Center Experience Stratified by TASC II Classification
Year: 2026
Type: article
Study design: Observational Study
Abstract: To evaluate the safety and effectiveness of directional atherectomy for superficial femoral artery (SFA) disease in patients with chronic limb ischemia (CLI) across Trans-Atlantic Inter-Society Consensus II (TASC II) lesion categories. A retrospective analysis was performed on 50 patients with CLI (Rutherford class 4–6) who underwent directional SFA atherectomy at a single center between January 2017 and June 2025. Lesions were classified using TASC II criteria. Technical success was defined as ≤30% residual stenosis with restoration of inline flow. Clinical outcomes included wound healing, limb salvage, amputation-free survival, and need for reintervention. Follow-up was conducted at 1, 6, and 12 months. The mean age was 66.3 years, with male predominance (74%). Advanced CLI (Rutherford 5–6) was observed in 62%. TASC II C and D lesions constituted 65%, and long-segment disease (>10 cm) was present in 62%. Technical success was achieved in 86%. Adjunctive balloon angioplasty was performed in 76%, and bailout stenting was required in 6%. Complications were minimal, including minor dissection (2%) and distal embolization (2%). Wound healing at 3 months was observed in 68%. Limb salvage at 6 months was 86%, with a 4% major amputation rate. Reintervention occurred in 12% within 6 months. Higher lesion complexity was associated with reduced clinical success (p = 0.04). Twelve-month amputation-free survival was 92%. Directional atherectomy of the SFA provides favorable technical and clinical outcomes in CLI, even in complex lesions, with low complication rates and limited stent use.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7162790835