[The treatment of obliterating arteriopathy of the lower limbs with Simpson's Atherocath].

Percutaneous transluminal angioplasty is limited by a high percentage of restenosis in the medium and long runs. Other arterial recanalization systems to be combined with or to be used in alternative to angioplasty are under investigation. Atherectomy with Simpson's catheter (Atherocath) allows mechanical removal of the atheromatous plaque, leaving a smooth lumen, and vessel dilatation with the same effects as those of angioplasty and coaxial Dotter catheters. A Hundred and ten atherectomies with Atherocath were performed by the authors in 103 patients for the treatment of 77 stenoses and 33 total occlusions. All patients had 36 months' follow-up. Immediate and medium patency rates are encouraging in femoropopliteal arteries; the actual role of the method in iliac arteries is still to be demonstrated. Atherectomy with Aterocath can be useful not only in the treatment of arterial stenoses, but also in complete obstructions, in combination with angioplasty. Other relevant indications are the removal of partially or totally obstructive intimal flaps complicating angioplasty, and treatment of such ulcerated lesions as the blue-digit syndrome.