Calcified, complex, long: atherectomy in femoropopliteal lesion

What are the advantages of atherectomy in the treatment of femoropopliteal lesions, and which patients are most likely to benefit? 

In this PVI 2025 interview, Dr Juliette Raffort-Lareyre and Dr Ralf Langhoff discuss how atherectomy can partially remove the underlying disease, enabling treatment of a broad range of lesions while keeping stent use to a minimum. 

They highlight the importance of preserving future treatment options, as patients remain suitable for bypass or stenting when needed, and explore how age, lesion complexity and the extent of calcification should influence patient selection. 

Finally, they discuss the rationale for combining atherectomy with DCB, with trials suggesting that the greater the calcium burden or lesion length, the greater the potential benefit of effective lesion preparation before DCB to achieve optimal luminal gain and support long-term patency.

Discover how atherectomy can fit into a tailored, stent-sparing approach to femoropopliteal disease.