Objective: To investigate the safety and efficacy of TurboHawk debulking combined with drug-coated balloon (DCB) in treatment of complicated femoropopliteal artery in-stent restenosis (ISR). 
Methods: Twenty-one patients with femoropopliteal artery ISR from May 2017 to May 2018 were treated by TurboHawk atherectomy plus DCB. Of the patients, 13 cases (61.9%) were males and 8 cases (38.1%) were females; the preoperative ABI was 0.45±0.14; the preoperative Rutherford classification was grade 2 in one case (4.7%), grade 3 in 3 cases (14.3%), grade 4 in 7 cases (33.3%), grade 5 in 8 cases (38.1%) and grade 6 in 2 cases (9.5%); the preoperative Tosaka classification was class I lesion in 2 cases (9.5%), class II lesion in 7 cases (33.3%), and class III lesion in 12 cases (57.1%).
Results: Technical and procedural success was achieved in all the 21 patients, and no surgery-associated adverse events occurred. The postoperative Rutherford classification was grade 0 in 2 cases (9.5%), grade 1 in 9 cases (42.8%), grade 2 in 3 cases (14.2%), grade 3 in one case (4.7%), grade 4 in 3 cases (14.2%) and grade 5 in 3 cases (14.2%). One patient died due to coronary heart disease on 9 months after operation, and one patient was lost to follow-up. Among the 18 patients who were followed up until 12 months, the ABI ranged from 0.69 to 1.45, with an average of 0.84±0.12, the primary patency rate was 83.3%, and the rate of freedom from clinically-driven target lesion revascularization was 88.9%.
Conclusion: TurboHawk debulking combined with DCB for complicated femoropopliteal artery ISR is safe and effective, and the short-term results are satisfactory.