069 - Trends in outcomes associated with the use of Auryon atherectomy system in a real-world setting
Purpose: Peripheral artery disease (PAD) is a common vascular condition that affects both quality of life and life expectancy. While endovascular treatments have evolved as the first line of treatment versus open surgical approaches for stenosis or occlusion of the lower limb arteries, they are associated with the risk of major dissections, perforations, embolic events. The present study details a single-center real-world case series assessing the safety and efficacy of the Auryon atherectomy system in patients with PAD.
Material and Methods: The Auryon atherectomy system (AngioDynamics Inc. Latham, NY) consists of a 355 nm wavelength solid-state Nd:YAG short pulse laser combined with dedicated optical catheters of various sizes. We retrospectively reviewed our single-center experience in patients with infrainguinal PAD (Rutherford 2-6) between March and December, 2020. Post-procedural patency was evaluated by duplex ultrasonography. Doppler waveforms and ABI with PVR were also evaluated to assess functionality before and following intervention. In addition, procedural adverse events were recorded to assess safety.
Results: A total of 55 patients were included in the present series. The average age was 73.7 years (range: 54-101) with 63.6% being male. 16.4% of patients treat only had above the knee lesions, 3.6% had lesions below the knee only, and 80.0% of patients had lesions above and below the knee. One patient (1.8%) had in-stent restenosis. 24 patients (43.6%) had chronic total occlusions and 24 patients (43.6%) had critical limb ischemia. 47 of the 55 of patients (85.5%) were deemed to have successful procedures defined as < 30% residual stenosis without any complications. Pre- and 30-day post-procedure ABI and TBI data was available for 19 patients with a mean 28% and 55% change from baseline, respectively. Stenosis/re-occlusion occurred in 14 patients (25.5%) at a mean of 168.9 days (range: 46:316). 14 patients (25.5%) required target lesion revascularization at a mean of 218 days (range: 57-375). 4 patients (7.3%) underwent minor amputations with a mean time to amputation of 110.7 days (range:16-176). No patients in our series experienced a procedure-related complication. There was one patient death unrelated to the procedure.
Conclusions: The Auryon laser system was shown to be safe and effective in this real-world patient population with no procedural adverse events or deaths and a low rate of amputations.