Endarterectomy Using the Lateral Approach with an Ultrasonic Surgical Aspirator Device for Heavily Calcified Peripheral Arterial Occlusive Disease

Objective: To present a new and easy technique for performing endarterectomy in patients with peripheral arterial occlusive disease (PAD) having dollop calcification at the common femoral artery (CFA). Materials and Methods: We developed a procedure for angioplasty for PAD using a supersonic surgical suction device, based on the new concept of "to create a new lumen to dig tunnel in calcification." Ultrasonic surgical aspiration device was inserted into the intravascular space from outside the area of the target lesion and only internal calcification was removed. Results: We performed this technique in three patients who had PAD with dollop calcification at CFA. We succeeded in performing endarterectomy easily and safely. This method does not require vascular wall closure suture at calcified lesion or intimal fixation suture of dollop calcification. Conclusion: We address the technical difficulty in treating highly calcified lesions that could not be dealt with conventional endarterectomy. Our new method is one of the options for revascularization of heavily calcified lesions.