Atherectomy in PVI: Time to Follow the Guidelines?

Introduction: 
Atherectomy, or debulking of atherosclerotic plaque, has been developed to assist interventionalists with obtaining maximal luminal gain in complex peripheral vascular interventions (PVI) and numerous atherectomy devices have become available over the last 2 decades, including directional atherectomy (longitudinal shaving of plaque with removal), rotational/orbital atherectomy (sanding of plaque with distal embolization), and ablative atherectomy (plaque destruction).

These devices, at significantly greater cost, are often used as an adjunct to angioplasty or stenting in recalcitrant or bulky lesions, or to reduce the need for stents in undesirable locations such as the common femoral or popliteal artery...