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Rotational atherectomy

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https://www.readbyqxmd.com/read/27894264/optical-coherence-tomography-findings-after-longitudinal-ablation-for-an-underexpanded-stent-in-a-heavily-calcified-lesion-a-case-report
#1
Masahiro Koide, Keiji Inoue, Akiko Matsuo, Hiroshi Fujita
BACKGROUND: Heavy coronary artery calcification is responsible for stent underexpansion, which is associated with increased in-stent restenosis. Here we report a case in which optical coherence tomography (OCT) demonstrated that the metal component of an underexpanded stent previously implanted in a heavy calcified lesion had been completely removed after ablation with rotational atherectomy. CASE PRESENTATION: An 83-year-old man with exertional angina was referred to our hospital...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27862848/safety-and-efficacy-of-rotational-atherectomy-for-the-treatment-of-undilatable-underexpanded-stents-implanted-in-calcific-lesions
#2
Luca A Ferri, Richard J Jabbour, Francesco Giannini, Susanna Benincasa, Marco Ancona, Damiano Regazzoli, Antonio Mangieri, Matteo Montorfano, Antonio Colombo, Azeem Latib
OBJECTIVES: Coronary stent underexpansion is a known risk factor for in-stent restenosis and stent thrombosis. There are limited options once noncompliant balloons have failed to achieve optimal stent expansion. Excimer Laser Coronary Angioplasty with contrast medium injection is one possibility, but not readily available. Rotational atherectomy is an alternative, and has been described in case reports, but concerns exist regarding safety. METHODS: All consecutive patients undergoing rotational atherectomy for symptomatic in-stent restenosis due to stent underexpansion resistant to noncompliant balloon postdilatation between January 2005 and December 2015 were analysed...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27821375/impact-of-lesion-calcification-on-angiographic-outcomes-after-absorb-everolimus-eluting-bioresorbable-vascular-scaffold-implantation-an-observation-from-the-absorb-japan-trial
#3
Masanobu Ohya, Kazushige Kadota, Yohei Sotomi, Ken Kozuma, Kengo Tanabe, Masaaki Uematsu, Tomohiro Kawasaki, Yoshihiro Morino, Tetsuya Tobaru, Koichi Nakao, Kouichi Tachibana, Koichi Kishi, Yoshisato Shibata, Shihwa Ying, Hajime Kusano, Gregg W Stone, Jeffery J Popma, Yoshinobu Onuma, Patrick W Serruys, Takeshi Kimura
AIMS: We investigated the impact of lesion calcification on angiographic outcomes after Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) implantation in comparison with those after cobalt chromium everolimus-eluting stent (CoCr-EES) implantation. METHODS AND RESULTS: The present post-hoc analysis of the ABSORB Japan randomized trial compared post-procedure and 13-month angiographic outcomes between patients implanted with BVS and CoCr-EES based on the presence or absence of calcification, excluding extremely heavily calcified lesions or lesions requiring rotational atherectomy...
November 8, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27801661/entrapment-of-rotational-atherectomy-burrs-in-freshly-implanted-stents-first-illustration-of-the-rolled-up-phenomenon
#4
Stephane Fournier, Juan F Iglesias, Andrea Zuffi, Eric Eeckhout, Piergorgio Tozzi, Olivier Muller
OBJECTIVES: We aimed to illustrate one of the mechanisms of rotational atherectomy burr entrapment in a coronary stent where the burr was rolled up in the stent's struts. METHODS: We report a case where the treatment of a mid right coronary artery (RCA) lesion using a rotational atherectomy device was attempted. During the procedure, the burr suddenly got stuck in a freshly implanted stent in the distal RCA. Despite several attempts and maneuvers, we were unable to pull back the burr...
November 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27778259/how-do-we-treat-complex-calcified-coronary-artery-disease
#5
Paul N Fiorilli, Saif Anwaruddin
Despite significant advances in treatment of coronary artery disease and improvements in interventional devices and techniques, the subset of obstructive calcified coronary artery disease remains challenging to treat. Percutaneous treatment of these lesions results in increased rates of procedural complications, as well as a higher risk of stent underexpansion and malapposition. This is associated with higher rates of restenosis, target lesion revascularization (TLR), and major adverse cardiac events (MACE)...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27759927/fracking-the-code-to-complete-revascularization
#6
Ravi S Hira, Larry S Dean
Provisional use of rotational atherectomy (RA) is indicated for procedural success in heavily calcified lesions. In the current study, RA use at three high volume percutaneous coronary intervention (PCI) centers between 2005 and 2013 was 1.4%. MACE rate was 17.8% at median follow-up of 22 months. Peripheral vascular disease (PVD), diabetes mellitus (DM), acute coronary syndrome (ACS), and SYNTAX > 23 were found to be independently associated with MACE. With increasing complexity of disease and SYNTAX score, there is usually an increase in severity of calcification and need for atherectomy...
October 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27757830/off-label-use-of-7fr-guideliner-in-the-bifurcation-coronary-intervention-protecting-2-side-branches
#7
Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27727589/coronary-rotational-atherectomy-using-burr-toartery-ratios-of-less-than-0-5
#8
C Mallikarjun Rao
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27709324/comparison-of-mid-term-clinical-outcomes-between-on-label-and-off-label-use-of-rotational-atherectomy
#9
Takayuki Mori, Kenichi Sakakura, Hiroshi Wada, Yousuke Taniguchi, Kei Yamamoto, Yusuke Adachi, Hiroshi Funayama, Shin-Ichi Momomura, Hideo Fujita
While rotational atherectomy (RA) is used for complex lesions in percutaneous coronary intervention, there are several contraindications such as unprotected left main stenosis or left ventricular dysfunction. We previously reported that the incidence of in-hospital complications was significantly greater in off-label as compared to on-label use RA. However, the mid-term clinical outcomes between off-label and on-label RA have not been investigated. The purpose of this study was to compare the mid-term clinical outcomes between off-label (n = 156) and on-label RA (n = 94)...
October 5, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27682657/successful-rotational-atherectomy-over-rg3-guidewire-after-failure-of-various-techniques-to-deliver-rotawire
#10
Umihiko Kaneko, Yoshifumi Kashima, Daitaro Kanno, Takuro Sugie, Ken Kobayashi, Tsutomu Fujita
Although performing rotational atherectomy (RA) requires guidewire exchange for the dedicated guidewire, RotaWire guidewire (Boston Scientific) exhibits much lower performance than conventional guidewire. Consequently, there are times when RotaWire cannot be advanced past the lesion independently or using a microcatheter exchange technique, rendering RA impossible. We present a case of a heavily calcified, device-uncrossable, and non-expansible chronic total occlusion lesion successfully revascularized with RA over RG3 guidewire (Asahi Intecc), which has a length of 330 cm, hydrophilic coating, and a 0...
September 28, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27650935/prevalence-indications-and-management-of-balloon-uncrossable-chronic-total-occlusions-insights-from-a-contemporary-multicenter-us-registry
#11
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, John Bahadorani, Anthony Doing, Ziad A Ali, Aris Karatasakis, Barbara A Danek, Bavana V Rangan, Aya J Alame, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Balloon uncrossable lesions can be challenging to treat, requiring specialized techniques and equipment. METHODS: We examined the prevalence, clinical and angiographic characteristics, management and procedural outcomes of balloon uncrossable lesions in a multicenter chronic total occlusion (CTO) percutaneous coronary intervention (PCI) registry. RESULTS: Between 2012 and 2016, 718 CTO PCIs (in which the occlusion was successfully crossed with a guidewire) were performed in 701 patients at 11 US centers...
September 21, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27591692/rotational-atherectomy-of-three-overlapping-stent-layers
#12
Tiberio M Frisoli, Harold Friedman, William W O'Neill
A patient was referred to us for Canadian Cardiovascular Society class III refractory angina. He was found to have in-stent restenosis within three layers of underexpanded stents implanted in 2004, 2011, and 2014. Rotational atherectomy safely yielded stent strut ablation (reduced to one layer), lesion expansion, and very good angiographic and physiologic results.
September 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27567021/first-prospective-multicenter-experience-with-the-7-french-glidesheath-slender-for-complex-transradial-coronary-interventions
#13
Adel Aminian, Juan F Iglesias, Carlos Van Mieghem, Andrea Zuffi, Angela Ferrara, Roukos Manih, Dariouch Dolatabadi, Jacques Lalmand, Shigeru Saito
PURPOSE: To assess the feasibility and safety of the 7 French (Fr) Glidesheath Slender for complex transradial (TR) percutaneous coronary interventions (PCI). BACKGROUND: The TR approach is increasingly used worldwide for coronary and peripheral vascular interventions. However, the small size of the radial artery remains an important limitation for the use of large-bore guiding catheters (>6 Fr), restricting thereby the treatment of highly complex lesions through the TR approach...
August 27, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27553204/very-long-term-follow-up-after-coronary-rotational-atherectomy-a-single-center-experience
#14
Aly Tohamy, Margo Klomp, Hein Putter, Amr Youssef, Hamdy Shams-Eddin, Mahmoud Abdelsabour, M J Schalij, J Wouter Jukema
We assessed the very long-term follow-up of a large cohort of unselected patients treated with coronary rotational atherectomy (RA). All 143 patients who underwent RA at our institution from 2000 to 2013 and with complete baseline and follow-up information were analyzed in a retrospective manner. Major adverse cardiac events (MACE) were defined as the composite of target vessel revascularization (TVR), acute myocardial infarction, and all-cause mortality. The mean follow-up was 8.2 years. The 10-year cumulative incidence of MACE for all patients was 57...
August 23, 2016: Angiology
https://www.readbyqxmd.com/read/27535209/type-4a-myocardial-infarction-incidence-risk-factors-and-long-term-outcomes
#15
Xiaoyu Yang, Hector Tamez, Carol Lai, Kalon Ho, Donald Cutlip
OBJECTIVES: To assess the incidence of and outcomes related to periprocedural (Type 4a) myocardial infarction (MI) in a cohort of patients undergoing percutaneous coronary intervention (PCI) for stable coronary disease or non ST-elevation acute coronary syndrome with stable or falling cardiac troponin levels. BACKGROUND: The 2012 Third Universal Definition for Type 4a MI has not been prospectively studied in routine clinical practice. METHODS: The study included 516 patients undergoing eligible PCI at a single institution...
August 18, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27534207/-percutaneous-transluminal-coronary-rotational-atherectomy-ptcra
#16
Yoshisato Shibata
No abstract text is available yet for this article.
June 20, 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27497363/rotational-atherectomy-of-undilatable-coronary-stents-stentablation-a-clinical-perspective-and-recommendation
#17
István F Édes, Zoltán Ruzsa, György Szabó, Árpád Lux, László Gellér, Levente Molnár, Fanni Nowotta, Ágota Hajas, Bálint Szilveszter, Dávid Becker, Béla Merkely
AIMS: Our aim was to examine procedural viability and midterm outcomes following the use of rotational atherectomy (RA) on malapposed, crippled, otherwise non-salvageable metallic stents (i.e., stentablation [SA]), and convey important procedural pointers for practitioners encountering such situations. METHODS AND RESULTS: Data on twelve SA subjects were analysed. The primary endpoint was procedural success: effective ablation of the malapposed stent and successful implantation of a new device...
2016: EuroIntervention
https://www.readbyqxmd.com/read/27486140/incidence-determinants-and-outcomes-of-coronary-perforation-during-percutaneous-coronary-intervention-in-the-united-kingdom-between-2006-and-2013-an-analysis-of-527-121-cases-from-the-british-cardiovascular-intervention-society-database
#18
Tim Kinnaird, Chun Shing Kwok, Evangelos Kontopantelis, Nicholas Ossei-Gerning, Peter Ludman, Mark deBelder, Richard Anderson, Mamas A Mamas
BACKGROUND: As coronary perforation (CP) is a rare but serious complication of percutaneous coronary intervention (PCI) the current evidence base is limited to small series. Using a national PCI database, the incidence, predictors, and outcomes of CP as a complication of PCI were defined. METHODS AND RESULTS: Data were prospectively collected and retrospectively analyzed from the British Cardiovascular Intervention Society data set on all PCI procedures performed in England and Wales between 2006 and 2013...
August 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27484728/long-term-results-of-transradial-rotational-atherectomy-for-heavily-calcified-coronary-artery-lesions
#19
Mantian Chen, Linqing Shang, Qing Zhou, Shu Meng, Yacheng Zhang, Yi Feng, Chengxing Shen, Genshan Ma
OBJECTIVE: Percutaneous coronary intervention (PCI) for the heavily calcified coronary lesions remains a challenge, and the periprocedural complication rates of the transfemoral approach are high. This study was conducted to investigate the feasibility and long-term results of the transradial approach for rotational atherectomy (RA) prior to stent implantation via the transradial approach in patients with heavily calcified coronary artery lesions. METHODS: RA followed by stent implantation via the transradial approach was performed in 47 patients with severely calcified coronary artery lesions in this retrospectively case-control study...
September 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/27473345/two-year-optical-coherence-tomography-findings-after-balloon-only-treatment-of-bioresorbable-scaffold-restenosis-in-a-calcified-coronary-lesion-a-case-report
#20
Abdelhakim Allali, Mohamed Abdel-Wahab, Gert Richardt
We report a case of a 65-year-old female patient treated with an everolimus-eluting bioresorbable scaffold (BRS) after rotational atherectomy of a severely calcified lesion of the left anterior descending coronary artery. The implanted BRS restenosed 10 months after implantation and was treated with a scoring balloon followed by drug-eluting balloons with good immediate and long-term results. To the best of our knowledge, this is the first report of a balloon-only treatment of a restenosis occurring more than 6 months after BRS implantation; angiographic and optical coherence tomography images after treatment and at two-year follow-up are presented...
July 29, 2016: Cardiology and Therapy
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