What were your objectives in evaluating the use of percutaneous atherectomy in 579 lesions with lower extremity ischemia?
Dr. McKinsey: Two key objectives at the center of any debate about optimal endovascular treatment of lower extremity PAD are long-term patency and limb salvage, especially in patients with CLI. In 2004, the SilverHawk atherectomy device presented us with a novel, minimally invasive endovascular alternative to the endovascular standard of angioplasty and adjunctive stenting. This directional debulking device has a small-caliber design with a high-speed carbide cutting disc capable of cutting long ribbons of obstructing atheroma and then storing them in the nose cone of the device for later removal. When we first started collecting the prospective dataset that ultimately included 579 consecutive percutaneous infrainguinal occlusive arterial lesions, the existing reports of short-term results of atherectomy involved only small numbers of patients with minimal follow-up. Evaluating these excisional atherectomy interventions over a period of 3 years as lead investigator collaborating with m
