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Rotational atherectomy

Francisco Javier Irazusta, Guillermo Galeote, Santiago Jimenez-Valero, Juan Caro-Codon, Angel Sanchez-Recalde, Raul Moreno
No abstract text is available yet for this article.
March 8, 2018: JACC. Cardiovascular Interventions
Jun Shiraishi, Nariko Koshi, Yuki Matsubara, Tetsuro Nishimura, Akira Shikuma, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
BACKGROUND: Experiences of rotational atherectomy (RA) followed by drug-coated balloon (DCB) dilation alone (RA/DCB) for de novo coronary artery lesion have been limited. CASE SERIES: Case 1 (65 year-old male) with silent myocardial ischemia and hemodialysis had old anterior myocardial infarction and intact LM/LCx, and underwent RA/DCB against a diffuse calcified lesion in the proximal LAD and a tandem lesion in the proximal RCA. Case 2 (88 year-old female) with post-infarction unstable angina had severe thrombocytopenia and anemia due to myelodysplastic syndrome (platelet 6000/μL, hemoglobin 8...
February 12, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Asaad A Khan, George D Dangas
Several chronic total occlusions (CTOs) may be undilatable despite successful wire passage; several techniques can be used for lesion preparation, such as high-pressure balloon inflations, rotational atherectomy laser, cutting balloon, and scoring balloons. Presence of moderate to severe calcification and lesion length over 40 mm in association with comorbidities, such as diabetes mellitus and reduced ejection fraction, may contribute to making a CTO lesion undilatable. Still, appropriate therapy selection for a patient with CTO should be individualized and procedure safety attended to...
March 1, 2018: Catheterization and Cardiovascular Interventions
Hoyle L Whiteside, Supawat Ratanapo, Arun Nagabandi, Deepak Kapoor
INTRODUCTION: Elective insertion of a percutaneous circulatory assist device (PCAD) in high-risk patients is considered a reasonable adjunct to percutaneous coronary intervention (PCI). There is limited data examining the safety and efficacy of rotational atherectomy (RA) without hemodynamic support in patients with reduced left ventricular ejection fraction (LVEF). METHODS: We retrospectively identified 131 consecutive patients undergoing RA without elective PCAD over a three-year period...
February 9, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Abdullah Almasoud, Daniel Walters, Ehtisham Mahmud
The feasibility, safety, and high technical success of robotically assisted percutaneous coronary intervention (PCI) for the treatment of both simple and complex coronary disease has been demonstrated. As the current generation robotic platform is limited to a rapid exchange system, orbital or rotational atherectomy cannot be performed robotically. However, excimer laser coronary atherectomy is performed with a rapid exchange catheter but its feasibility during robotically assisted PCI is unknown. We report the successful use of laser atherectomy during two complex robotically assisted PCI procedures using the CorPath GRX robotic system...
March 9, 2018: Catheterization and Cardiovascular Interventions
Tae-Hoon Kim, Nelson Chavarria, Khagendra Dahal, Michael Azrin, Juyong Lee
Repeated restenotic events are common in superficial femoral artery and as of late, Viabahn stent grafts have been FDA (U.S. Food & Drug Administration) approved. Viabahn have been particularly attractive given that they provided a physical barrier for the development of neointimal hyperplasia. This particular feature however, also underscores one of the main limitations of the therapy; providing a physical barrier of collateral circulation and predisposing to acute limb ischemia. Viabahn endograft thrombosis is characterized by stent edge stenosis and endograft thrombosis...
December 25, 2017: Annals of Vascular Diseases
Tadayuki Uetani, Tetsuya Amano
No abstract text is available yet for this article.
March 8, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Damiano Regazzoli, Daisuke Hachinohe, Ozan M Demir, Mauro Carlino, Julien Lemoine, Satoru Mitomo, Enrico Poletti, Max Amor, Antonio Colombo, Lorenzo Azzalini
Candidates for percutaneous coronary revascularization are becoming progressively older and more complex. A combination of factors related to the patient, lesion, and/or hemodynamic conditions may increase the risk of adverse events. Therefore, when a high-risk procedure is identified, it is crucial to provide the patient with adequate support in order to safely perform percutaneous coronary intervention (PCI). We report the case of a 77-year-old man with moderate left ventricular dysfunction and stage IV chronic kidney disease who underwent successful recanalization of a chronically occluded left anterior descending artery...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Piotr Kübler, Wojciech Zimoch, Michał Kosowski, Brunon Tomasiewicz, Artur Telichowski, Krzysztof Reczuch
INTRODUCTION: Transfemoral approach (TFA) may be preferred access site in order to facilitate complex percutaneous procedures such as rotational atherectomy (RA). Notwithstanding, there is a growing evidence that transradial approach (TRA) is associated with lower access site complication rates and even lower mortality. The aim was to assess in-hospital and 1-year outcomes in patients undergoing RA using TRA, in comparison to TFA. METHODS: A single center observational study included all consecutive patients, who underwent RA from 2010 to 2015...
February 21, 2018: Journal of Interventional Cardiology
Kei Yamamoto, Kenichi Sakakura, Yousuke Taniguchi, Yoshimasa Tsurumaki, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
Because rotational atherectomy (RA) has several unique complications, such as burr entrapment, vessel perforation, and slow flow, it is important for interventional cardiologists to be familiar with bailout procedures for such complications. The principal part of bailout procedures is to keep a guidewire in the target coronary artery during the procedure. However, it is not easy to keep a guidewire in the same position during the removal of a burr because the length of the RA guidewires is 300 cm, and the removal of a burr requires collaboration between the primary operator and an assistant...
February 20, 2018: International Heart Journal
Jin-Woo Kim, You-Hong Lee, Jae-Hyeong Park, Jae-Hwan Lee
Stentablation by rotational atherectomy has been reported as an option to correct underexpanded stents. Due to concerns of excessive stent damage, distal embolization of metal particles, excessive heat generation, and burr entrapment in the stent, stentablation has been considered the last choice to manage underexpanded stents. Here, we report a case of a stuck and entrapped atherectomy burr inside an underexpanded and undilatable stent, which made withdrawal of therotablation burr during rotational atherectomy difficult...
February 20, 2018: International Heart Journal
Edward Koifman, Hector M Garcia-Garcia, Kayode O Kuku, Alexandre H Kajita, Kyle D Buchanan, Arie Steinvil, Toby Rogers, Nelson L Bernardo, Robert Lager, Robert A Gallino, Itsik Ben-Dor, Augusto D Pichard, Rebecca Torguson, Jiaxiang Gai, Lowell F Satler, Ron Waksman
We aimed to compare the safety and efficacy of rotational atherectomy (RA) and orbital atherectomy (OA) during percutaneous coronary intervention in an all-comer population with severely calcified lesions. We included all patients who underwent percutaneous coronary intervention with OA or RA in our institution from October 2013 until October 2016. Comparison of baseline and procedural characteristics, along with acute complication rates and postprocedural cardiac enzyme elevation, was performed. There were 191 RA and 57 OA patients...
February 13, 2018: American Journal of Cardiology
Daoyuan Si, Guohui Liu, Yaliang Tong, Yuquan He
RATIONALE: Inadequate stent expansion due to rigid calcified may result in restenosis lesions, but the available options are limited. PATIENT CONCERNS: We report a case via the trans-radial approach of the severely underexpanded freshly deployed stent due to heavily calcified plaques DIAGNOSES:: Coronary angiography revealed that there was no adequate expansion of the freshly deployed stent. INTERVENTIONS: Under the guide of intravascular ultrasound (IVUS), rotational atherectomy (RA) successfully ablated the stent layers and the protruding calcified plaque...
February 2018: Medicine (Baltimore)
Michael Megaly, Yader Sandoval, Matthew P Lillyblad, Emmanouil S Brilakis
BACKGROUND: Coronary atherectomy, orbital or rotational, is frequently used for plaque modification in patients with heavily calcified lesions. Atherectomy can be associated with clinically significant bradyarrhythmias or transient atrioventricular block requiring temporary pacemaker insertion, mainly in lesions involving the right coronary artery or a dominant left circumflex artery. Bradyarrhythmias may be mediated by endogenous release of adenosine from red blood cell breakdown. Aminophylline, an adenosine antagonist, can prevent adenosine-mediated bradyarrhythmias...
February 15, 2018: Journal of Invasive Cardiology
Mario Iannaccone, Salvatore Colangelo, Carlo Di Mario, Roberto Garbo
No abstract text is available yet for this article.
February 13, 2018: EuroIntervention
Marco Hernández-Enríquez, Francisco Campelo-Parada, Thibault Lhermusier, Frédéric Bouisset, Jérôme Roncalli, Meyer Elbaz, Didier Carrié, Nicolas Boudou
OBJECTIVES: To analyze the procedural and long-term outcomes of the use of rotational atherectomy (RA) in underexpanded stents in our cohort and to provide an overview of currently available data on this technique. BACKGROUND: Stent underexpansion (SU) has been related to stent thrombosis and restenosis. RA has been used to treat undilatable SU as a bail-out strategy with encouraging results. METHODS: This is an observational, single-center study...
January 25, 2018: Journal of Interventional Cardiology
Khaldoon Alaswad, Mir Babar Basir, Akshay Khandelwal, Theodore Schreiber, William Lombardi, William O'Neill
Currently, there are no data on the use of mechanical circulatory support (MCS) in patients without severely depressed left ventricular ejection fraction (LVEF) during high-risk percutaneous coronary intervention (PCI). We analyzed data from the global catheter-based ventricular assist device (cVAD) registry on the clinical use of MCS in high-risk PCI in patients without severely depressed LVEF, defined as LVEF > 35%. Patients without cardiogenic shock from the catheter-based ventricular assist device registry, who underwent elective or urgent PCI with an Impella 2...
December 25, 2017: American Journal of Cardiology
Yihao Zheng, Yang Liu, John J Pitre, Joseph L Bull, Hitinder S Gurm, Albert J Shih
Rotational atherectomy (RA) uses a high-speed rotating burr introduced via a catheter through the artery to remove hardened atherosclerotic plaque. Current clinical RA technique lacks consensus on burr size and rotational speed. The rotating burr orbits inside the artery due to the fluid force of the blood. Different from a common RA technique of upsizing burrs for larger luminal gain, a small burr can orbit to treat a large lumen. A 3D computational fluid dynamics (CFD) model was developed to simulate the burr motion and study the fluid flow and force in RA...
January 24, 2018: Annals of Biomedical Engineering
Peter Tajti, Dimitri Karmpaliotis, Khaldoon Alaswad, Catalin Toma, James W Choi, Farouc A Jaffer, Anthony H Doing, Mitul Patel, Ehtisham Mahmud, Barry Uretsky, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
BACKGROUND: The prevalence, treatment and outcomes of balloon undilatable chronic total occlusions (CTOs) have received limited study. METHODS: We examined the prevalence, clinical and angiographic characteristics, and procedural outcomes of percutaneous coronary interventions (PCIs) for balloon undilatable CTOs in a contemporary multicenter US registry. RESULTS: Between 2012 and 2017 data on balloon undilatable lesions were available for 425 consecutive CTO PCIs in 415 patients in whom guidewire crossing was successful: 52 of 425 CTOs were balloon undilatable (12%)...
January 23, 2018: Catheterization and Cardiovascular Interventions
William A Gray, Lawrence A Garcia, Ali Amin, Nicolas W Shammas
OBJECTIVES: To report on procedural, safety, and effectiveness outcomes of real-world practice with the Jetstream rotational atherectomy system for treatment of femoropopliteal artery lesions. BACKGROUND: Safety and effectiveness of treatment with the Jetstream device has been demonstrated in clinical trials, but outcomes during real-world clinical practice have yet to be examined. METHODS: 241 patients (66% male, mean age 67years, 41% diabetes; Rutherford 1-3) with de novo or restenotic (non-stent) femoropopliteal lesions ≥4cm in length were recruited...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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