Hand-Assisted Rotational Atherectomy for Severe and Long Superficial Femoral Artery Calcification: A Step-by-Step Guide.
Journal
JACC. Case reports
Journal Volume
30
Journal Issue
19
Pages
103960
ISSN
2666-0849
Date Issued
2025-07-16
Author(s)
Abstract
Objectives: Hand-assisted rotational atherectomy (HARA) using a 2.0-mm burr is an innovative approach for treating severely calcified superficial femoral artery (SFA) lesions, enhancing procedural success and facilitating optimal revascularization. Key Steps: The key steps are as follows: 1) ultrasound-guided antegrade femoral access; 2) controlled rotational atherectomy passes at 140,000 to 160,000 rpm; 3) manual compression applied opposite the burr to enhance targeted debulking; and 4) drug-coated balloon angioplasty or drug-eluting stent deployment. Potential Pitfalls: Burr entrapment can be mitigated by avoiding excessive force and allowing gradual advancement. Take-Home Message: HARA is a safe, effective, and reproducible technique for treating severely calcified SFA lesions, improving procedural success and optimizing outcomes with drug-coated balloon angioplasty or deployment of a drug-eluting stent. © 2025 The Authors
Subjects
cardiovascular disease
peripheral vascular disease
vascular disease
Type
journal article