{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:05:47Z","timestamp":1790330747219,"version":"4.1.0"},"reference-count":35,"publisher":"Hogrefe Publishing Group","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vasa"],"abstract":"<jats:p>Summary: Background: Severe arterial calcification poses a major challenge to endovascular therapy (EVT) in peripheral artery disease (PAD). Orbital atherectomy (OAS) is used to modify plaque and enhance luminal gain, potentially improving EVT outcomes, but long-term evidence remains limited. Patients and methods: This retrospective single-center study assessed the mid-term outcomes of OAS in heavily calcified infrainguinal disease. We included symptomatic PAD patients (Rutherford 2\u20136) with \u226570% stenosis undergoing OAS for above- and below-the-knee (BTK) arterial lesions. Results: From 2018 to 2023, 78 patients underwent EVT for 83 infrainguinal lesions with OAS. Most were male (84.6%; 66\/78) and had significant cardiovascular risk factors. Lesions were located in the femoropopliteal (FP) segment in 28.9% (24\/83) and in BTK in 71.1% (59\/83). Chronic limb threatening ischemia (CLTI) was significantly more frequent in BTK disease (13.0% [3\/23] vs. 76.4% [42\/55], p &lt; .001). Mean lesion length was 101.8 \u00b1 72.9 mm in FP and 133.0 \u00b1 102.7 mm in BTK lesions, with chronic total occlusions in 25.0% (6\/24) and 49.2% (29\/59), respectively. One-year freedom from target lesion revascularization was 90.5% \u00b1 6.5% for FP and 73.1% \u00b1 7.7% for BTK lesions. One-year survival was 95.7% \u00b1 4.3% in claudicants and 62.4% \u00b1 7.8% CLTI patients (logrank p = .001). Major limb amputation occurred in .0% (0\/22) of FP and 4.4% (2\/45) of BTK cases at 30 days. Conclusions: OAS demonstrated feasibility in this highly selected cohort; however, its comparative efficacy remains uncertain.<\/jats:p>","DOI":"10.1024\/0301-1526\/a001313","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:36:43Z","timestamp":1790329003000},"source":"Crossref","is-referenced-by-count":0,"title":["Mid-term results of orbital atherectomy in heavily calcified lesions above and below the knee"],"prefix":"10.1024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2403-1698","authenticated-orcid":true,"given":"Sandra","family":"D\u00fcsing","sequence":"first","affiliation":[{"name":"Department of Angiology, University Hospital Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Wittig","sequence":"additional","affiliation":[{"name":"Department of Angiology, University Hospital Leipzig, Germany"},{"name":"Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the 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