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Purpose <p>This study aimed to identify predictors of distal embolization following JETSTREAM™ atherectomy for calcified femoropopliteal lesions and evaluate 1-year clinical outcomes in a real-world setting.</p> Materials and Methods <p>We analyzed data from 109 patients with 121 calcified femoropopliteal lesions who underwent JETSTREAM™ atherectomy therapy between October 2022 and December 2023 as part of the JET-FORWARD study, a retrospective, single-arm, multicenter study. Distal embolization incidence and risk factors were the primary focus, while 1-year primary patency served as efficacy outcome measures. Safety outcomes also included mortality and major target limb amputation.</p> Results <p>The mean lesion length was 15.5 ± 9.4&#xa0;cm, and the technical success rate—defined as residual stenosis less than 30% and absence of grade C or higher dissection post-procedure—was 93.4%. Angiographically significant distal embolization occurred in 35.5% of cases during the index procedure. On multivariate analysis, poor tibial runoff (≤ 1 tibial artery), severe small artery disease, nodular calcification, and debulking lengths &gt; 10&#xa0;cm were independent predictors of distal embolization. The 1-month mortality and 1-year limb salvage rates were 2.8% and 98.9%, respectively. The 1-year primary patency rate was 88.9%.</p> Conclusion <p>Angiographically significant distal embolization occurred in 35.5% of cases with JETSTREAM atherectomy, while 1-year outcomes remained favorable in treating femoropopliteal lesions. This study also identified four predictors of distal embolization. Thus, careful risk factor evaluation and patient selection are essential during atherectomy.</p> Graphical Abstract <p></p>

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One-year Clinical Outcomes and Predictors of Distal Embolization After JETSTREAM™ Atherectomy for Calcified Femoropopliteal Artery Lesions: Results From the JET-FORWARD Study

  • 期刊论文

  • 发表日期：

    2025年5月22日

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  • Shunsuke Kojima,
  • Takahiro Tokuda,
  • Akiko Tanaka,
  • Naoki Yoshioka,
  • Kohei Yamaguchi,
  • Takashi Yanagiuchi,
  • Kenji Ogata,
  • Tatsuro Takei,
  • Tatsuya Nakama

摘要

Purpose

This study aimed to identify predictors of distal embolization following JETSTREAM™ atherectomy for calcified femoropopliteal lesions and evaluate 1-year clinical outcomes in a real-world setting.

Materials and Methods

We analyzed data from 109 patients with 121 calcified femoropopliteal lesions who underwent JETSTREAM™ atherectomy therapy between October 2022 and December 2023 as part of the JET-FORWARD study, a retrospective, single-arm, multicenter study. Distal embolization incidence and risk factors were the primary focus, while 1-year primary patency served as efficacy outcome measures. Safety outcomes also included mortality and major target limb amputation.

Results

The mean lesion length was 15.5 ± 9.4 cm, and the technical success rate—defined as residual stenosis less than 30% and absence of grade C or higher dissection post-procedure—was 93.4%. Angiographically significant distal embolization occurred in 35.5% of cases during the index procedure. On multivariate analysis, poor tibial runoff (≤ 1 tibial artery), severe small artery disease, nodular calcification, and debulking lengths > 10 cm were independent predictors of distal embolization. The 1-month mortality and 1-year limb salvage rates were 2.8% and 98.9%, respectively. The 1-year primary patency rate was 88.9%.

Conclusion

Angiographically significant distal embolization occurred in 35.5% of cases with JETSTREAM atherectomy, while 1-year outcomes remained favorable in treating femoropopliteal lesions. This study also identified four predictors of distal embolization. Thus, careful risk factor evaluation and patient selection are essential during atherectomy.

Graphical Abstract