Bidirectional biopsy forceps approach for calcified common femoral artery lesion

Abstract

Background

In cases of highly calcified lesions of the common femoral artery with intermittent claudication, it is common to try exercise therapy first and, if there is little improvement, to try surgical endarterectomy, but the method of treatment may vary depending on whether a vascular surgeon is available at the same institution. Also, atherectomy devices may not yet be available in some centers. Therefore, an atherectomy is sometimes performed with biopsy forceps for myocardial biopsy of highly calcified lesions in the common femoral artery to the proximal part of the superficial femoral artery.

Case description

We report three cases with intermittent claudication in which atherectomy with biopsy forceps was performed for severe calcified lesions of the common femoral artery using a crossover approach from the contralateral femoral artery and a retrograde distal approach from the ipsilateral peripheral side. In all three cases, intermittent claudication and ankle-brachial pressure index improved, and the postoperative course was good without complications.

Conclusions

Calcified plaque ablation with biopsy forceps requires many points of caution with off-label use, but the bidirectional approach allows for effective and efficient ablation.