This was a 83 year old Native American man with rest pain and atrophic skin changes on the dorsum of the foot. Slide #2 “Distal Run-off”.
ATA showed 80-90% stenosis on the IVUS, which was then treated with a 2.25 Rotablator and 3.5mm x 220mm angioplasty. The IVUS also showed three areas of 60-65% stenosis within the P2 and P3 segments that were hidden on the initial angiogram. Native Popliteal diameter was 6.3cm on IVUS.
An 8fr RDC Guiding Catheter (“Mach 1” by Boston Scientific) was used to convert the 2.25mm Rotablator into a directional Atherectomy catheter to treat the popliteal stenosis.
The Rotablator Atherectomy is frequently used to treat tibial arterial atherosclerosis but has limited utility in larger caliber arteries. By using a sharply angled guiding catheter we can help to bias the rotational Atherectomy burr into the plaque of a femoral or popliteal are terry lesion. This expands the clinical utility of a tried and proven Atherectomy modality and contributes to mission sustainability.
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