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Rotational atherectomy

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https://www.readbyqxmd.com/read/29139601/utility-of-the-acc-aha-lesion-classification-as-a-predictor-of-procedural-30-day-and-12-month-outcomes-in-the-contemporary-percutaneous-coronary-intervention-era
#1
James Theuerle, Matias B Yudi, Omar Farouque, Nick Andrianopoulos, Peter Scott, Andrew E Ajani, Angela Brennan, Stephen J Duffy, Christopher M Reid, David J Clark
BACKGROUND: Correlations between the ACC/AHA coronary lesion classification and clinical outcomes in the contemporary percutaneous coronary intervention (PCI) era are not well established. METHODS: We analyzed clinical characteristics and outcomes according to ACC/AHA lesion classification (A, B1, B2, C) in 13,701 consecutive patients from the Melbourne Interventional Group (MIG) registry. Patients presenting with STEMI, cardiogenic shock and out-of-hospital cardiac arrest were excluded...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29118889/successful-treatment-of-iatrogenic-external-iliac-artery-perforation-with-covered-stent-case-report-and-review-of-the-literature
#2
Muhammad Umer Awan, Bassam Omar, Ghazanfar Qureshi, Ghulam Mustafa Awan
Retroperitoneal hemorrhage from iliac artery injury is a potentially serious complication of vascular interventional procedures leading to hemorrhagic shock and death if not diagnosed early and treated promptly. We report a 70-year-old male admitted to our facility with non-ST-elevation myocardial infarction, whose heart catheterization revealed left anterior descending artery (LAD) with 80% proximal, 95% mid and 100% distal disease. The left circumflex and right coronary arteries were 100% occluded proximally and received collaterals from the LAD...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/29113866/intravascular-ultrasound-enhances-the-safety-of-rotational-atherectomy
#3
REVIEW
Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Yoshimasa Tsurumaki, Shin-Ichi Momomura, Hideo Fujita
Intravascular ultrasound (IVUS) is mainly used in PCI to treat complex lesions, such as left main bifurcation, chronic total occlusion and calcified lesions. Although IVUS yields useful information such as the presence of napkin-ring calcification, the role of IVUS in rotational atherectomy (RA) is not fully appreciated. Recently, since the deliverability and crossability of IVUS catheters have improved, IVUS should be attempted before RA. Even if the IVUS catheter cannot cross the lesion, IVUS provides information just proximal to the target lesion, which would be useful in the selection of the appropriate guidewire and burr size...
September 23, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29106070/transverse-partial-stent-ablation-with-rotational-atherectomy-for-suboptimal-culotte-technique-in-left-main-stem-bifurcation
#4
Giovanni Luigi De Maria, Rajesh Kharbanda, Adrian P Banning
Longitudinal rotational atherectomy of metal struts is well described as bail-out strategy to treat undilatable instent restenosis. Ablation of metal stent struts jailing the ostium of a major side branch in a coronary bifurcation is not described. In the current report, we describe a case of "transverse" rotational atherectomy to treat a failure of culotte stenting in a left main stem bifurcation. We document for the first time in vivo and in man the effect of this strategy using optical coherence tomography...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29080193/correction-to-cost-effectiveness-of-orbital-atherectomy-compared-to-rotational-atherectomy-in-treating-patients-with-severely-calcified-coronary-artery-lesions-in-japan
#5
Jan B Pietzsch, Benjamin P Geisler, Fumiaki Ikeno
In the original publication of this article, in Abstract the 1-year mortality of OAS should be stated as 4.7 and not 5.5%.
October 27, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29068164/predictors-of-in-hospital-effectiveness-and-complications-of-rotational-atherectomy-from-the-orpki-polish-national-registry-2014-2016
#6
Rafał Januszek, Zbigniew Siudak, Artur Dziewierz, Dariusz Dudek, Stanisław Bartuś
OBJECTIVE: The aim of the study was to assess trends in the use and periprocedural outcomes of rotational atherectomy (RA) in Poland between January 2014 and December 2016. BACKGROUND: In recent years, due to the aging population, RA is becoming more commonly used to treat heavily calcified coronary artery stenoses. METHODS: Data were prospectively collected using the Polish Cardiovascular Intervention Society national registry on all percutaneous coronary intervention (PCI) procedures performed in Poland...
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29051975/impact-of-lesion-complexity-on-long-term-vascular-response-to-cobalt-chromium-everolimus-eluting-stent-five-year-follow-up-optical-coherence-tomography-study
#7
Shoichi Kuramitsu, Shinjo Sonoda, Tomohiro Shinozaki, Hiroyuki Jinnouch, Yoshitaka Muraoka, Takenori Domei, Makoto Hyodo, Shinichi Shirai, Kenji Ando, Yutaka Otsuji
The impact of lesion complexity on long-term vascular response to cobalt-chromium everolimus-eluting stent (CoCrEES) remains unclear. We sought to evaluate them using optical coherence tomography (OCT). A total of 47 patients with 58 lesions treated only with CoCrEES and no target-vessel events within 5 years after implantation were prospectively enrolled and underwent 5-year follow-up OCT. Quantitative parameters and qualitative characteristics of the neointima were evaluated using multilevel logistic or linear regression models with random effects at three levels: lesion, cross-section (CS), and strut...
October 19, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29045041/orbital-and-rotational-atherectomy-during-percutaneous-coronary-intervention-for-coronary-artery-calcification
#8
Michael S Lee, Jonathan S Gordin, Gregg W Stone, Samin K Sharma, Shigeru Saito, Ehtisham Mahmud, Jeff Chambers, Philippe Généreux, Richard Shlofmitz
Severe coronary artery calcification (CAC) increases the complexity of percutaneous coronary intervention (PCI) by inhibiting optimal stent expansion, leading to an increased risk of death, myocardial infarction, repeat revascularization, and stent thrombosis. Coronary atherectomy modifies and debulks calcified plaque to facilitate PCI. Although there is no clear consensus, and further studies are needed, the decision to perform atherectomy should be based upon the presence of fluoroscopic CAC or with the use of intravascular imaging...
October 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28988708/efficacy-of-a-heparin-based-rota-flush-solution-in-patients-undergoing-rotational-atherectomy
#9
Hoyle L Whiteside, Supawat Ratanapo, Albert Sey, Abdullah Omar, Deepak Kapoor
INTRODUCTION: The efficacy of heparin based flush solutions in rotational atherectomy (RA) has not been validated. Recently, a single center study demonstrated the feasibility of an alternative flush solution with 10,000U of unfractionated heparin (UFH) in 1L of normal saline. We aimed to evaluate the safety and efficacy of an alternative flush solution intermittently utilized at our institution. METHODS: We retrospectively identified 150 patients undergoing RA over a three year period...
August 25, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28966325/rotational-atherectomy-followed-by-drug-coated-balloon-dilation-for-left-main-in-stent-restenosis-in-the-setting-of-acute-coronary-syndrome-complicated-with-right-coronary-chronic-total-occlusion
#10
Jun Shiraishi, Keisuke Shoji, Takashi Yanagiuchi, Masaki Yashige, Akira Shikuma, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
An 83-year-old man presented with recurrent acute coronary syndrome (ACS) at the left main coronary artery (LMCA) complicated with ostial chronic total occlusion (CTO) in the right coronary artery (RCA) (RCA-CTO). At the first LMCA-ACS approximately 1 year earlier, he had undergone LMCA-crossover stenting with a biolimus-eluting stent in the presence of RCA-CTO. At the second LMCA-ACS, we angiographically confirmed severe in-stent restenosis in the distal LMCA, in addition to angled severe stenosis in the just proximal LCx, and performed primary PCI for the LMCA bifurcation lesion under intra-aortic balloon pumping support...
October 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28965230/optical-frequency-domain-imaging-guided-rotational-atherectomy-followed-by-drug-coated-balloon-dilation-to-the-non-calcified-lesion-in-a-patient-with-severe-thrombocytopenia
#11
Jun Shiraishi, Muneo Ohshiro, Yuki Matsubara, Masayuki Hyogo, Hitoji Uchiyama, Takahisa Sawada
No abstract text is available yet for this article.
September 30, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28931790/clinical-characteristics-and-long-term-outcomes-of-rotational-atherectomy%C3%A3-j2t-multicenter-registry
#12
Iwao Okai, Tomotaka Dohi, Shinya Okazaki, Kentaro Jujo, Makoto Nakashima, Hisao Otsuki, Kazuki Tanaka, Hiroyuki Arashi, Ryuta Okabe, Fukuko Nagura, Yugo Nara, Hiroshi Tamura, Takeshi Kurata, Hideyuki Kawashima, Hiroyuki Kyono, Junichi Yamaguchi, Katsumi Miyauchi, Ken Kozuma, Nobuhisa Hagiwara, Hiroyuki Daida
BACKGROUND: Rotational atherectomy (RA) is an adjunct tool for the management of heavily calcified coronary lesions during percutaneous coronary intervention (PCI), but the long-term clinical outcomes of RA use remain unclear in this drug-eluting stent era.Methods and Results:This multi-center registry assessed the characteristics and outcomes of patients treated by RA for calcified coronary lesions between 2004 and 2015. Among 1,090 registered patients, mean age was 70±10 years and 815 (75%) were male...
September 21, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28916604/coronary-perforation-complicating-percutaneous-coronary-intervention-in-patients-with-a-history-of-coronary-artery-bypass-surgery-an-analysis-of-309-perforation-cases-from-the-british-cardiovascular-intervention-society-database
#13
Tim Kinnaird, Richard Anderson, Nick Ossei-Gerning, James Cockburn, Alex Sirker, Peter Ludman, Mark de Belder, Thomas W Johnson, Samuel Copt, Azfar Zaman, Mamas A Mamas
BACKGROUND: The evidence base for coronary perforation (CP) occurring during percutaneous coronary intervention in patients with a history of coronary artery bypass surgery (PCI-CABG) is limited and the long-term effects unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during PCI-CABG were defined. METHODS AND RESULTS: Data were analyzed on all PCI-CABG procedures performed in England and Wales between 2005 and 2013. Multivariate logistic regressions and propensity scores were used to identify predictors of CP and its association with outcomes...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28890526/five-year-clinical-outcomes-after-drug-eluting-stent-implantation-following-rotational-atherectomy-for-heavily-calcified-lesions
#14
Hiroyuki Jinnouchi, Shoichi Kuramitsu, Tomohiro Shinozaki, Takashi Hiromasa, Yohei Kobayashi, Yasuaki Takeji, Mizuki Miura, Hisaki Masuda, Yukiko Matsumura, Yuhei Yamaji, Kenichi Sakakura, Takenori Domei, Yoshimitsu Soga, Makoto Hyodo, Shinichi Shirai, Kenji Ando
BACKGROUND: Percutaneous coronary intervention for heavily calcified lesions requires rotational atherectomy (RA). Long-term clinical outcomes after drug-eluting stent (DES) implantation following (RA) for heavily calcified lesions remain unclear. We assessed 5-year clinical outcomes after DES implantation following RA.Methods and Results:Between March 2006 and September 2011, 219 consecutive patients with 219 lesions treated with DES following RA, were retrospectively enrolled. The cumulative 5-year incidence of target-lesion revascularization (TLR) and definite stent thrombosis (ST) were assessed...
September 9, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28875395/cost-effectiveness-of-orbital-atherectomy-compared-to-rotational-atherectomy-in-treating-patients-with-severely-calcified-coronary-artery-lesions-in-japan
#15
Jan B Pietzsch, Benjamin P Geisler, Fumiaki Ikeno
Compared to rotational atherectomy (RA), orbital atherectomy (OA) has been shown to decrease procedure failure and reintervention rates in the treatment of severely calcified coronary artery lesions. Our objective was to explore the cost-effectiveness of OA compared to RA in the Japanese healthcare system. A decision-analytic model calculated reintervention rates and consequent total 1-year costs. Effectiveness inputs were therapy-specific target lesion revascularization (TLR) rates and all-cause mortality, pooled from clinical studies...
September 5, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28867375/calcified-plaque-modification-alters-local-drug-delivery-in-the-treatment-of-peripheral-atherosclerosis
#16
Abraham R Tzafriri, Fernando Garcia-Polite, Brett Zani, James Stanley, Benny Muraj, Jennifer Knutson, Robert Kohler, Peter Markham, Alexander Nikanorov, Elazer R Edelman
BACKGROUND: Calcific atherosclerosis is a major challenge to intraluminal drug delivery in peripheral artery disease (PAD). OBJECTIVES: We evaluated the effects of orbital atherectomy on intraluminal paclitaxel delivery to human peripheral arteries with substantial calcified plaque. METHODS: Diagnostic angiography and 3-D rotational imaging of five fresh human lower limbs revealed calcification in all main arteries. The proximal or distal segment of each artery was treated using an orbital atherectomy system (OAS) under simulated blood flow and fluoroscopy...
October 28, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28860893/calcification-remodeling-index-characterized-by-cardiac-ct-as-a-novel-parameter-to-predict-the-use-of-rotational-atherectomy-for-coronary-intervention-of-lesions-with-moderate-to-severe-calcification
#17
Mengmeng Yu, Yuehua Li, Wenbin Li, Zhigang Lu, Meng Wei, Jiayin Zhang
OBJECTIVE: To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. MATERIALS AND METHODS: Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area...
September 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28818353/does-calcium-burden-impact-culprit-lesion-morphology-and-clinical-results-an-adapt-des-ivus-substudy
#18
Peiren Shan, Gary S Mintz, Bernhard Witzenbichler, D Christopher Metzger, Michael J Rinaldi, Peter L Duffy, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Philippe Généreux, Aaron Crowley, Ajay J Kirtane, Gregg W Stone, Akiko Maehara
BACKGROUND: Increasing coronary lesion calcification is thought to be associated with adverse percutaneous coronary intervention (PCI) and clinical outcomes. We investigated the effects of calcium burden on culprit lesion morphology and clinical events after intravascular ultrasound (IVUS)-guided PCI in the ADAPT-DES study. METHODS: ADAPT-DES was a prospective, multicenter registry of 8582 consecutive patients undergoing successful PCI using DES. A pre-specified virtual histology (VH)-IVUS substudy of 638 culprit lesions (638 patients) had both pre- and post-PCI VH-IVUS...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28803800/-ping-pong-technique-for-treating-a-balloon-uncrossable-chronic-total-occlusion
#19
Michael Koutouzis, Grigorios Avdikos, Georgios Nikitas, Theodoros Zografos, Ioannis Tsiafoutis, Maria Agelaki, Efstathios Lazaris
Balloon uncrossable lesions are a well-known challenge during chronic total occlusion (CTO) interventions. The technique of using two different catheters into the same coronary artery, the so-called "ping-pong" technique, is a technique described for treating complications during percutaneous coronary intervention (PCI), like perforations or rotational atherectomy burr entrapment. We describe a case where the "ping-pong" technique was successfully used to facilitate treatment of a balloon uncrossable CTO lesion...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28781024/intraluminal-intensity-of-blood-speckle-on-intravascular-ultrasound-a-novel-predictor-of-periprocedural-myocardial-injury-after-coronary-stenting
#20
Yoshiyuki Okuya, Yuichi Saito, Hideki Kitahara, Takashi Nakayama, Yoshihide Fujimoto, Yoshio Kobayashi
The difference in the intraluminal intensity of blood speckle (IBS) on integrated backscatter-intravascular ultrasound (IB-IVUS) across a coronary artery stenosis (i.e., ΔIBS) has previously shown a negative correlation with fractional flow reserve, reflecting an impaired coronary blood flow. Periprocedural myocardial injury (PMI) after coronary stenting has also been associated with coronary circulatory dysfunction. The aim of this study was to investigate the relation between ΔIBS after coronary stenting and PMI...
October 1, 2017: American Journal of Cardiology
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