{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:20:45Z","timestamp":1790367645761,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T00:00:00Z","timestamp":1657929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","award":["ISR\u20102017\u201010908"],"award-info":[{"award-number":["ISR\u20102017\u201010908"]}],"id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to compare the ability of two different atherectomy modalities, the directional atherectomy system (DAS) and the orbital atherectomy system (OAS), to modify plaque and augment luminal gain as evaluated by angiography and intravascular ultrasound (IVUS) in patients with symptomatic femoro\u2010popliteal peripheral arterial disease (PAD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Atherectomy is frequently utilized in the treatment of complex PAD. To date, there are no head\u2010to\u2010head comparisons of existing devices and their selection is based mostly on operator preference rather than on supportive data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a single\u2010center, prospective, randomized trial designed to assess the impact of DAS in comparison to OAS on atherosclerotic plaque. Pre\u2010 and postatherectomy lesion characterization was performed by angiography and IVUS. Drug\u2010coated balloon (DCB) angioplasty was performed after atherectomy with similar analysis repeated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients were randomized to undergo either DAS or OAS. Pretreatment angiographic and IVUS characteristics were similar in the DAS and OAS groups. DAS led to a greater reduction in plaque volume throughout the entire lesion (5.9% vs. 1.1%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). This corresponded to a greater increase in total vessel and lumen volume by IVUS (161.5\u2009mm<jats:sup>3<\/jats:sup> vs. 50.2\u2009mm<jats:sup>3<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; 178.6\u2009mm<jats:sup>3<\/jats:sup> vs. 47.0\u2009mm<jats:sup>3<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u20090.004, respectively), as well as a reduction in angiographic stenosis (40% vs. 70%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). After DCB, 10 patients required stenting for suboptimal results in the OAS group compared with two\u00a0in the DAS group (<jats:italic>p<\/jats:italic>\u2009=\u20090.021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to OAS, DAS demonstrated a greater plaque volume reduction and luminal gain with significantly fewer stents needed post\u2010DCB.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30339","type":"journal-article","created":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T06:13:10Z","timestamp":1658038390000},"page":"687-695","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Directional versus orbital atherectomy of femoropopliteal artery lesions: Angiographic and intravascular ultrasound outcomes"],"prefix":"10.1002","volume":"100","author":[{"given":"Anvar","family":"Babaev","sequence":"first","affiliation":[{"name":"NYU Langone Medical Center  New York New York 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1910-8447","authenticated-orcid":false,"given":"Akiko","family":"Maehara","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation Columbia University  New York New York 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