Atherectomy in the Treatment of Peripheral Arterial Disease—A Case Series to Demonstrate Preferable Indications with Good Outcomes and a Literature Review

Background: Endovascular therapy for lower-limb arterial disease is widely performed today. A vast array of sheaths, catheters, wires, balloon types, stents, and tools such as atherectomy, thrombectomy, and lithotripsy devices are now available to achieve the best outcomes in terms of vessel patency and ultimately limb salvage. The use of atherectomy devices, however, has raised some controversies in terms of outcome efficacy, cost effectiveness, and safety profile in various series and studies. Objectively, the types and disease pattern in these studies are also greatly heterogeneous. Methods: Here, we reported three cases which exemplify how these atherectomy devices have served as a valuable tool, especially for patients with complex and heavily calcified lesions. Results: The three cases highlighted scenarios where atherectomy displayed good outcomes, each involving the use of atherectomy devices to treat highly calcified vessels. Conclusions: Despite the concerns with atherectomy devices, we believe that with proper selection, patients will benefit most from their ability to achieve the best outcomes of both vessel patency and limb salvage.