Washington, D.C. — The CardioVascular Coalition (CVC) today commended the publication of a landmark paper providing the most comprehensive review to date of atherectomy use in peripheral endovascular interventions. The analysis underscores the strength of the existing evidence base and reaffirms the safety and efficacy of atherectomy when appropriately utilized for patients with peripheral artery disease (PAD).

You can view the published research Atherectomy Systematic Literature Review and Metanalysis Publication in JSCAI online here.

Despite more than three decades of use, atherectomy has faced recent criticism regarding its clinical value and supporting evidence. This new review, encompassing over 35 years of research, provides a data-driven and balanced assessment that highlights both the breadth and quality of the available studies.

Key Findings from the Review

The analysis evaluated 322 original research articles through November 2024, representing the most comprehensive dataset on peripheral atherectomy to date. Among its findings:

• High-quality evidence base: Included 12 meta-analyses, 19 randomized controlled trials (RCTs), and 96 prospective observational studies.

  
  

• Favorable long-term outcomes: Across 51 studies (4,806 patients), one-year patency averaged 75.4%, significantly higher than reported rates for uncoated balloon angioplasty (47.4%) and drug-coated balloons (DCBs) without atherectomy (67.6–67.9%).

  
  

• Low complication rates: One-year target lesion revascularization (15.6%), major amputation (1.7%), and mortality (2.8%) rates were comparable or superior to outcomes for balloon angioplasty or DCB therapy.

  
  

• Reduced need for stenting: Bailout stenting occurred in only 9.3% of cases, aligning with or improving upon rates reported for alternative endovascular techniques.

CVC Statement on the Findings

“These results reinforce what many vascular specialists have long recognized—that atherectomy, when used in properly selected cases, offers a safe and effective option for patients with peripheral artery disease,” said Dr. Bob Tahara, a vascular surgeon and the past president of OEIS. “This comprehensive review demonstrates that the body of evidence supporting atherectomy is robust, and that outcomes are both clinically meaningful and consistent across decades of research.”

The CVC noted that the study’s conclusions—showing low rates of amputation, mortality, and reintervention—are particularly important for advancing patient-centered care in PAD management. The Coalition called for continued investment in comparative effectiveness studies to further refine treatment selection and optimize outcomes for patients.