Decalcification of a Heavily Calcified Common Femoral Artery and its Bifurcation with a Cavitron Ultrasonic Surgical Aspirator

摘要

Introduction Surgical endarterectomy is the preferred method for treating occlusive disease of the common femoral artery (CFA). However, endarterectomy is not always straightforward in cases with heavily calcified plaque. To overcome this limitation, a new method for decalcification, which utilizes a Cavitron ultrasonic surgical aspirator (CUSA) has been developed. Report The method involves full exposure of the calcified lesion. Following an arteriotomy, protruding calcification is removed using the CUSA, taking care to avoid vessel perforation. Preservation of the medial calcified layer can be accomplished by the accurate control provided by the device, which enables smooth termination in the distal area of the normal wall and does not require a tacking suture. A total of 12 patients underwent decalcification of 13 common femoral artery (CFA) lesions using CUSA with vein patch angioplasty. Concomitant profundaplasty was performed in five cases. The only intra-operative complication was perforation of the arterial wall in one patient, while another had a wound infection that required reintervention. Discussion Decalcification of a heavily calcified CFA with CUSA appears to be feasible, although long-term follow-up examinations are warranted. Highlights ? Surgical endarterectomy for a heavily calcified common femoral artery and its bifurcation can be challenging. ? The authors have developed a new method for decalcification that utilizes a Cavitron ultrasonic surgical aspirator. ? An important advantage of this procedure is that there is no need for tacking sutures.