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CardioVascular and Interventional Radiology

, Volume 36, Issue 1, pp 69–74 | Cite as

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

  • Marianne BrodmannEmail author
  • Peter Rief
  • Harald Froehlich
  • Andreas Dorr
  • Thomas Gary
  • Philipp Eller
  • Franz Hafner
  • Hannes Deutschmann
  • Gerald Seinost
  • Ernst Pilger
Clinical Investigation

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.

Keywords

Arterial intervention Thrombectomy Stenting Stent graft Drug eluting stents Restenosis Stenosis Peripheral vascular disease 

Notes

Conflict of interest

M. Brodmann: Honoraria from Bayer Healthcare, Böhringer Ingelheim, Actelion; P. Rief: FWF no conflict of interest; H. Froehlich: Grants pending from FWF; A. Dorr: no conflict of interest; T. Gary: Grants pending, Honoraria Bayer Healthcare; P. Eller: Grants pending, FWF; F. Hafner: no conflict of interest; H. Deutschmann: no conflict of interest; G. Seinost: no conflict of interest; and E. Pilger: Honaria from Bayer Healthcare, Böhringer Ingelheim, Takeda.

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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Marianne Brodmann
    • 1
    Email author
  • Peter Rief
    • 1
  • Harald Froehlich
    • 1
  • Andreas Dorr
    • 1
  • Thomas Gary
    • 1
  • Philipp Eller
    • 1
  • Franz Hafner
    • 1
  • Hannes Deutschmann
    • 2
  • Gerald Seinost
    • 1
  • Ernst Pilger
    • 1
  1. 1.Division of AngiologyMedical University of GrazGrazAustria
  2. 2.Division of Interventional RadiologyMedical University GrazGrazAustria

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