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Advancements in endovascular techniques and treatments have helped many patients avoid traditional, open surgery for peripheral artery disease (PAD). Conventional balloon angioplasty has been widely used for focal lesions and has a high success rate. Yet, elastic recoil, dissection and poor primary and secondary patency rates for long lesions have necessitated other procedural methods for areas of severe calcification. Thus, as a way to “debulk” plaque from diseased arteries, an atherectomy is performed. In the majority of cases, atherectomy is combined with a low-pressure balloon angioplasty procedure without actually placing a stent. However, in other cases, an atherectomy is used to prep the blood vessel before stenting to prevent restenosis or re-narrowing of the vessel.

When it comes to femoropopliteal, or small vessel infrapopliteal disease, four methods of atherectomy may be used: plaque excision (directional) atherectomy, rotational atherectomy/aspiration, laser atherectomy and orbital atherectomy. Depending on the device used, calcified plaque can be cut, shaved, sanded or vaporized.

Atherectomy and Treatment of Lower Extremity Peripheral Artery Disease (PAD)

With peripheral artery disease (PAD) on the rise, management and treatment modalities for lower extremity PAD has also expanded, moving beyond the stent-first approach. While angioplasty remains an effective treatment, there are a greater number of stent fractures and restenosis reported as a result of specific movements (compression, torsion, bending) in relation to the femoral and other lower-extremity arteries. Thus, an atherectomy is appealing for several reasons.

In lesions that are greater than 10 cm., or in those with heavy calcification, the effectiveness of stents is limited. The same is true in constrained areas and joint spaces, which are believed to be one reason for stent failure. While some atherectomy procedures have the ability to provide revascularization without the need for additional treatment (directional atherectomy), other positive aspects of atherectomy is that it is non-invasive, and calcified plaque can be removed without damaging the vessel wall. This also reduces the chance of acute complications.

Without question, atherectomy devices and methodology continue to evolve. While atherectomy is a promising treatment method for PAD, specifically of the lower extremity vessels, appropriate usage and device selection are key.

Dr. Alan I. Benvenisty, MD, a prominent vascular and endovascular surgeon in New York City, delivers personalized patient care that is tailored to specific vascular conditions. With careful consideration of the patient’s present and past health history, family health history and lifestyle, as well as extensive knowledge regarding the anatomy of lower extremity vessels, patients feel at ease with Dr. Benvenisty’s conscientious approach to treatment. To meet with Dr. Benvenisty, contact our office on Amsterdam Avenue to schedule an appointment.

Our Patient Reviews

Dr. Alan I. Benvensity MD

4.9 / 5.0

Based on 10 reviews

Max P.

Dr. Benvenisty is very professional and thorough. Listens to his patients and truly cares. Fantastic doctor and lovely staff

Andrew C.

Could not have asked for more. Genuinely passionate, skilled and cares about his patients.

Yossi S.

A doctor who gives the best care to his patients and treats the disease with best care and great staff.

Renata B.

Dr. Benvenisty was excellent and helped us with my husband's extensive leg swelling related to diabetes. We had another specialist who didn't help us last year. We're planning to stay with Dr. Benvenisty now! He's detailed oriented, matter-of-fact and friendly. An excellent doctor I would strongly recommend.


Dr. Benvenisty treated my mother in the ER during this time of the covid outbreak. He was a part of a fantastic team of doctors that were brought in to find out what was ailing my mother. He is first and for most experienced in many areas as my mother was diagnosed with pancreatitis. Although he transferred the surgery to another member of his team, he gave me his mobile and kept me informed of her condition/diagnosis at a time where I was unable to be with her myself because of this pandemic. His heart, compassion, understanding and bedside manner are things that I will not ever forget. He is an excellent doctor and truly a great human being.

Howard L.

Dr. Benvenisty is the most caring physician that I know. He is brilliant, highly ethical and trustworthy. His knowledge extends well beyond his specialty. He makes referrals to the best possible physicians. I know Dr. Benvenisty for 25 years and have complete confidence in him.

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440 West 114th St, Second Floor
New York, NY 10025

(212) 523-4706

Monday & Friday 9:00 AM – 5:00 PM