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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 1/2013

01-02-2013 | Clinical Investigation

Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial

Authors: Marianne Brodmann, Peter Rief, Harald Froehlich, Andreas Dorr, Thomas Gary, Philipp Eller, Franz Hafner, Hannes Deutschmann, Gerald Seinost, Ernst Pilger

Published in: CardioVascular and Interventional Radiology | Issue 1/2013

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Abstract

Background

Due to intimal hyperplasia instent reobstruction in the femoropopliteal arterial segment is still an unsolved problem. Different techniques have been discussed in case of reintervention to guarantee longlasting patency rate.

Methods

We conducted a randomized, controlled, pilot trial comparing Silverhawk atherectomy with percutaneous transluminal angioplasty (PTA) in patients with a first instent reobstruction in the femoropopliteal arterial segment, to evaluate intima media thickness (IMT) within the treated segment, as a parameter of recurrence of intimal hyperplasia.

Results

In a total 19 patients were included: 9 patients in the atherectomy device and 10 patients in the PTA arm. IMT within the treated segment was statistically significantly elevated in all patients treated with the Silverhawk device versus the patients treated with PTA. The obvious differentiation in elevation of IMT in nonfavor for patients treated with the Silverhawk device started at month 2 (max IMT SH 0.178 mm vs. IMT PTA 0.1 mm, p = 0.001) with a spike at month 5 (max IMT SH 0.206 mm vs. IMT PTA 0.145 mm, p = 0.003) and a decline once again at month 6 (max IMT SH 0.177 mm vs. IMT PTA 0.121 mm, p = 0.02). The values for mean IMT performed the same way.

Conclusions

Although Silverhawk atherectomy provides good results at first sight, in the midterm follow-up of treatment of first instent restenosis it did not perform better than PTA as it showed elevated reoccurrence of intimal media hyperplasia.
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Metadata
Title
Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial
Authors
Marianne Brodmann
Peter Rief
Harald Froehlich
Andreas Dorr
Thomas Gary
Philipp Eller
Franz Hafner
Hannes Deutschmann
Gerald Seinost
Ernst Pilger
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
CardioVascular and Interventional Radiology / Issue 1/2013
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-012-0479-9

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