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Figure 11 Extraction Atherectomy of the Superficial Femoral Artery
A 64-year-old woman with right leg claudication (ankle-brachial index 0.68) despite aggressive medical therapy and an exercise program underwent abdominal angiography with lower extremity runoff. (A) An occluded right superficial femoral artery (SFA) just beyond the ostium is noted with three vessel runoff to the foot via collaterals. (B) The occlusion in the right SFA (arrow) is just beyond the ostium of the vessel. (C) After traversing the stenosis with a 0.035-inch guidewire (Terumo, Japan), the wire is exchanged over an end-hole catheter to a 0.014-inch BMW wire (Guidant, Temecula, California), and atherectomy with a SilverHawk (Foxhollow, California) catheter is performed. (D) Final angiographic result after significant plaque extraction. Duplex ultrasound follow-up at 12 months revealed no evidence of restenosis at the site of atherectomy and the patient remained clinically asymptomatic. CFA = common femoral artery.
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