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Directional atherectomy of a heavy calcified axillary artery stenosis inducing critical hand ischemia

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Abstract

The presence of a severe calcified peripheral artery lesion is responsible for a poor response to balloon dilation, due to significant acute vessel recoil and frequent flow-limiting dissections requiring stent implantation. This possibility could be associated with very high compression and/or fracture rates particularly in cases of lesion located at the mobile joints. In this setting directional atherectomy offers the theoretical advantages of eliminating stretch injury on arterial walls and reducing the restenosis rate by direct plaque excision. In this report, we present a case of critical hand ischemia due to a heavily calcified axillary artery lesion managed by directional atherectomy and balloon angioplasty followed by immediate angiographic success and sustained clinical benefit up to 3 years of follow-up.

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The authors report no financial relationships or conflicts of interest regarding the content herein.

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Authors and Affiliations

  1. Catheterization Laboratory, Cardio-Vascular Department, Istituto Clinico Humanitas Mater Domini, Via Gerenzano 2, 21053, Castellanza, VA, Italy

    Angelo Anzuini & Alfonso Ielasi

  2. Catheterization Laboratory, Cardiology Department, Istituto Clinico Città Studi, Milan, Italy

    Altin Palloshi & Gianfranco Aprigliano

Authors
  1. Angelo Anzuini
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  2. Altin Palloshi
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  3. Gianfranco Aprigliano
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  4. Alfonso Ielasi
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Correspondence to Angelo Anzuini.

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Anzuini, A., Palloshi, A., Aprigliano, G. et al. Directional atherectomy of a heavy calcified axillary artery stenosis inducing critical hand ischemia. Cardiovasc Interv and Ther 28, 300–302 (2013). https://doi.org/10.1007/s12928-013-0163-2

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  • DOI: https://doi.org/10.1007/s12928-013-0163-2

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