Purpose: Atherosclerotic plaques in peripheral arterial disease (PAD) include fatty, mixed, and calcified types. Plaque burden is significantly associated with restenosis, reintervention, and amputation-free survival. Rotational and aspirational atherectomy (RAA) may effectively remove such plaques. This study aimed to evaluate long-term outcomes of RAA for infrainguinal PAD. Methods: Patients with infrainguinal lesions underwent revascularization using the Jetstream Atherectomy System (Boston Scientific). This 60-month extension assessed primary patency rate (PPR) and clinically driven target lesion revascularization (CD-TLR). Kaplan-Meier curves were used for survival analysis; P < 0.05 was considered statistically significant. Results: A total of 150 patients (mean age, 70.9 years; male, 86.0%; 65.4% with diabetes) were enrolled. The mean lesion length was 15.8 cm, with 74.0% occlusions and 47.3% severe calcification. Lesions were sclerotic (72.4%), thrombosclerotic (13.4%), thrombotic (9.4%), or in-stent (4.7%). A drug-coated balloon (DCB) was used in 85.5% of cases. PPR at 1, 3, and 5 years was 84.1%, 68.1%, and 58.5%, respectively. CD-TLR rates were 93.0%, 81.5%, and 67.4%, respectively. The benefit of DCB was sustained through 3 years but attenuated thereafter, highlighting the need for extended follow-up in infrainguinal interventions. Conclusion RAA demonstrated durable 5-year patency and safety outcomes. Device type, DCB use, lesion morphology, and calcium grade did not significantly influence long-term results. Lesion complexity remains the primary predictor of clinical outcome. Despite the complexity of infrainguinal lesions, the use of RAA demonstrated sustained patency through 3 years, with lesion complexity (particularly TASC classification) emerging as the most critical predictor of long-term success.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.

Peripheral artery disease (PAD) is a common vascular condition affecting over 200 million people worldwide. It is primarily characterized by stenosis or occlusion of peripheral arteries due to atherosclerosis. The infrainguinal segment is frequently involved in PAD, making revascularization decisions for infrainguinal arterial disease (IAD) complex. Multiple factors, including the patient’s condition and anatomical characteristics, must be carefully considered when determining the optimal treatment approach. Once these factors are evaluated, the first revascularization strategy is selected from among open, endovascular, or hybrid modalities, based on high-level evidence. Endovascular therapy is widely accepted as the standard treatment for simple IAD, with balloon angioplasty and stenting being the commonly used techniques.However, advancements in endovascular techniques have enabled the treatment of increasingly complex lesions. Additionally, drug-based technologies have enhanced the durability of treatment outcomes, including improvements in primary patency rates and freedom from target lesion revascularization. Similar to surgical endarterectomy, percutaneous atherectomy has been developed to remove atherosclerotic plaques and mitigate intimal calcification. The purpose of this paper is to present an algorithm for revascularization of IAD through a comprehensive review of studies comparing the outcomes of various treatment modalities.

Idiopathic nonspecific interstitial pneumonia (iNSIP) is recognized as a distinct entity among various types of idiopathic interstitial pneumonias. It is identified histologically by the nonspecific interstitial pneumonia pattern. A diagnosis of iNSIP is feasible once secondary causes or underlying diseases are ruled out. Usually presenting with respiratory symptoms such as shortness of breath and cough, iNSIP has a subacute or chronic course. It predominantly affects females aged 50 to 60 years who are non-smokers. Key imaging findings on chest high-resolution computed tomography include bilateral reticular opacities in lower lungs, traction bronchiectasis, reduced lung volumes and, ground-glass opacities. Abnormalities are typically diffuse across both lungs with subpleural distributions. Treatment often involves systemic steroids, either alone or in combination with other immunosuppressants, although evidence supporting effectiveness of these treatments is limited. Prognosis is generally more favorable for iNSIP than for idiopathic pulmonary fibrosis, with many studies reporting a 5-year survival rate above 70%. Antifibrotic agents should be considered in a condition, termed progressive pulmonary fibrosis, where pulmonary fibrosis progressively worsens.