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orbital atherectomy

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https://www.readbyqxmd.com/read/28722196/safety-of-orbital-atherectomy-in-patients-with-left-ventricular-systolic-dysfunction
#1
Evan Shlofmitz, Perwaiz Meraj, Rajiv Jauhar, Sanjum S Sethi, Richard A Shlofmitz, Michael S Lee
OBJECTIVES: We evaluated the angiographic and clinical outcomes in patients with severely calcified lesions and systolic dysfunction who underwent orbital atherectomy (OA). We hypothesized that OA would provide similar outcomes in patients with systolic dysfunction compared with patients with preserved systolic function. BACKGROUND: Systolic dysfunction is associated with an increased risk of adverse clinical events after percutaneous coronary intervention (PCI)...
July 19, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28707447/cto-revascularization-obstacles-and-options-in-balloon-nonpenetrable-lesions
#2
EDITORIAL
On Topaz
CTO lesions resisting balloon crossing are located in moderate/severe tortuous coronary arteries contain more moderate/severe calcification burden and carry a higher J-CTO score as compared with balloon crossable CTO lesions. CTO lesions resisting balloon crossing do not constitute a homogenous group. In 25% of the patients, the resisting CTO was caused by stent restenosis and thrombus is an integral component of CTO in addition to calcium and fibrosis. The excimer laser and rotational/orbital atherectomy are among useful debulking technologies capable of creating a "pilot recanalization channel" in the CTO that enables completion of the revasularization...
July 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28656738/mid-term-outcomes-of-consecutive-998-cases-of-coronary-atherectomy-in-contemporary-clinical-practice
#3
Nishtha Sareen, Usman Baber, Melissa Aquino, Sonny Sayseng, Joseph Sweeny, Nitin Barman, Vishal Kapur, Annapoorna Kini, Samin K Sharma
OBJECTIVES: To compare clinical and safety endpoints with use of rotational (RA) and orbital (OA) atherectomy in a large patient population with moderate to severely calcified lesions undergoing percutaneous coronary intervention (PCI). BACKGROUND: Coronary artery calcification (CAC) has been recognized as a risk factor for adverse outcomes with coronary artery disease (CAD). Though atheroablative techniques, RA and OA have been used extensively, comparison of their clinical and safety endpoints is lacking...
June 27, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28648437/utility-of-adjunctive-modalities-in-coronary-chronic-total-occlusion-intervention
#4
REVIEW
Hemal Bhatt, Sean Janzer, Jon C George
Coronary chronic total occlusion (CTO) intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI) attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28548625/acute-procedural-outcomes-of-orbital-atherectomy-for-the-treatment-of-common-femoral-artery-disease-sub-analysis-of-the-confirm-registries
#5
Michael S Lee, Daniel Heikali, Jihad Mustapha, George Adams, Ehtisham Mahmud
This analysis compared the angiographic outcomes of patients treated with orbital atherectomy for calcified common femoral artery (CFA) and superficial femoral artery (SFA) disease. The ideal revascularization strategy for CFA disease is unknown. Endarterectomy has been considered the standard of care for CFA disease for over 50 years. Endovascular intervention is becoming more commonly used to revascularize the CFA given the advances in technology and the less invasive nature of the procedure. Patient demographics, lesion characteristics, and procedure data for all CONFIRM patients with at least one CFA lesion location ( n=147 patients; n=200 lesions) were compared to patients with at least one SFA lesion location ( n=1508 patients; n=2367 lesions)...
May 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#6
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Jeremy Kong, Natalya Neverova, Richard Shlofmitz
OBJECTIVES: This study analyzed the outcomes of patients who presented with non-ST-elevation myocardial infarction (NSTEMI) and subsequently underwent orbital atherectomy for severe coronary artery calcification (CAC). BACKGROUND: Patients who present with NSTEMI have increased risk for death and recurrent MI after percutaneous coronary intervention (PCI). Patients with severe CAC have worse outcomes after PCI.Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
May 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28382804/optical-coherence-tomography-guided-therapy-of-in-stent-restenosis-for-peripheral-arterial-disease
#7
REVIEW
Michael K Lichtenberg, Jeffrey G Carr, Jaafer A Golzar
Approximately 27 million people in Europe and North America currently have peripheral arterial disease (PAD). The endovascular treatment of stenosis or blocked peripheral arteries in PAD include percutaneous transluminal angioplasty with or without a drug coated balloon (DCB), atherectomy (rotational, directional, orbital or laser), and stenting. The development of next generation peripheral stents and drug-coated stents have led to the improved treatment of complex superficial femoral artery (SFA) lesions, and consequently increased their usage...
August 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28303692/combined-radial-tibial-access-strategy-and-radial-tibial-reverse-cart-in-a-patient-with-aortobifemoral-graft-and-complex-superficial-femoral-artery-occlusion
#8
Elias B Hanna, Davey L Prout
We present the case of a patient with a history of aortobifemoral grafting who presented with left lower extremity ischemic rest pain. Aortofemoral angiography was performed through a left radial access and showed a long, calcified total occlusion of the left superficial femoral artery (SFA) and a subtotal popliteal occlusion. The popliteal artery and SFA were crossed retrogradely through a 4-Fr anterior tibial access; the retrograde devices went subintimally and did not reenter at the common femoral level...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295971/mid-term-outcomes-of-orbital-atherectomy-combined-with-drug-coated-balloon-angioplasty-for-treatment-of-femoropopliteal-disease
#9
T Raymond Foley, Ryan P Cotter, Damianos G Kokkinidis, Daniel D Nguyen, Stephen W Waldo, Ehrin J Armstrong
PURPOSE: To assess the intraprocedural and mid-term outcomes of orbital atherectomy (OA) combined with drug-coated balloon (DCB) angioplasty for the treatment of calcified femoropopliteal disease. METHODS: In this single-center cohort, 89 patients (139 lesions) were treated with DCB angioplasty for claudication or critical limb ischemia (CLI). Angiographic characteristics and procedural outcomes were reviewed for patients treated with or without adjunctive OA. Lesion calcification was graded using two previously published scoring systems, the angiographic calcium score (ACS) and the peripheral artery calcification scoring system (PACSS)...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28258729/comparison-of-rotational-atherectomy-versus-orbital-atherectomy-for-the-treatment-of-heavily-calcified-coronary-plaques
#10
COMPARATIVE STUDY
Michael S Lee, Kyung Woo Park, Evan Shlofmitz, Richard A Shlofmitz
We evaluated the outcomes of patients with severe coronary artery calcification (CAC) who underwent rotational atherectomy (RA) and orbital atherectomy (OA). Severe CAC increases the complexity of percutaneous coronary intervention (PCI) because of the difficulty in optimizing stent expansion, leading to worse clinical outcomes. Both devices are effective treatment strategies for severe CAC. No comparisons have been performed to evaluate the clinical outcomes after RA and OA. The outcomes of 67 patients with severe CAC who underwent RA from July 2012 to June 2015 and 60 patients who underwent OA from February 2014 to September 2016 were evaluated...
May 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28255104/-single-operator-technique-for-advancing-the-orbital-atherectomy-device
#11
Michael S Lee, Heajung Nguyen, Daniel Philipson, Richard A Shlofmitz
OBJECTIVE: We assessed the feasibility and safety of the "single-operator" technique in which the operator autonomously advanced the orbital atherectomy (OA) device while maintaining wire position. BACKGROUND: Severe coronary artery calcification (CAC) increases the complexity of percutaneous coronary intervention (PCI), and is associated with lower procedural success rates and higher rates of adverse outcomes, including death, myocardial infarction, target-vessel revascularization, and stent thrombosis...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28191873/orbital-atherectomy-treatment-of-severely-calcified-coronary-lesions-in-patients-with-impaired-left-ventricular-ejection-fraction-one-year-outcomes-from-the-orbit-ii-study
#12
Michael S Lee, Brad J Martinsen, Richard Shlofmitz, Evan Shlofmitz, Arthur C Lee, Jeffrey Chambers
AIMS: Percutaneous coronary intervention (PCI) of severe coronary artery calcification (CAC) is challenging. The ORBIT II study demonstrated the safety and efficacy of orbital atherectomy (OA) in patients with severe CAC. Microparticulate liberated during OA may disturb coronary microcirculation. We evaluated OA treatment in patients with left ventricular systolic dysfunction. METHODS AND RESULTS: Patients were grouped by left ventricular ejection fraction (LVEF): 26-40% (n=33), 41-50% (n=90), and >50% (n=314)...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28180008/use-of-orbital-atherectomy-in-acute-myocardial-infarction-via-the-transradial-approach
#13
REVIEW
Samer Mowakeaa, Branden Snyder, Nikolaos Kakouros
Severe coronary artery calcifications pose an ongoing challenge when performing percutaneous coronary interventions, resulting in an increased likelihood of procedural complications. Orbital atherectomy (OA) has emerged as a promising technology that helps improve outcomes in this complex patient population. Its safety and efficacy are yet to be demonstrated in the setting of acute myocardial infarction. We present a case of a patient with acute ST-elevation myocardial infarction (STEMI) evaluated with emergent transradial coronary angiography...
December 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28162989/orbital-atherectomy-for-treating-de-novo-severely-calcified-coronary-lesions-3-year-results-of-the-pivotal-orbit-ii-trial
#14
Michael Lee, Philippe Généreux, Richard Shlofmitz, Daniel Phillipson, Bynthia M Anose, Brad J Martinsen, Stevan I Himmelstein, Jeff W Chambers
BACKGROUND/PURPOSE: The presence of heavy coronary artery calcification increases the complexity of percutaneous coronary intervention (PCI) and increases the incidence of major adverse cardiac events (MACE): death, myocardial infarction (MI), target vessel revascularization (TVR), and stent thrombosis. The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial reported low rates of procedural, 30-day, 1-year, and 2-year ischemic complications after treatment of de novo, severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc...
June 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28145873/incidence-of-bradycardia-and-outcomes-of-patients-who-underwent-orbital-atherectomy-without-a-temporary-pacemaker
#15
Michael S Lee, Heajung Nguyen, Richard Shlofmitz
OBJECTIVE: We analyzed the incidence of bradycardia and the safety of patients with severely calcified coronary lesions who underwent orbital atherectomy without the insertion of a temporary pacemaker. BACKGROUND: The presence of severely calcified coronary lesions can increase the complexity of percutaneous coronary intervention due to the difficulty in advancing and optimally expanding the stent. High-pressure inflations to predilate calcified lesions may cause angiographic complications like perforation and dissection...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28116818/outcomes-in-elderly-patients-with-severely-calcified-coronary-lesions-undergoing-orbital-atherectomy
#16
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Richard A Shlofmitz
OBJECTIVES: We evaluated the clinical outcomes of elderly patients who underwent orbital atherectomy for the treatment of severe coronary artery calcification (CAC) prior to stenting. BACKGROUND: Percutaneous coronary intervention (PCI) of severe CAC is associated with worse clinical outcomes including death, myocardial infarction (MI), and target vessel revascularization (TVR). The elderly represents a high-risk group of patients, often have more comorbid conditions, and have worse outcomes after PCI compared to younger patients...
April 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28089999/impact-of-impaired-renal-function-in-patients-with-severely-calcified-coronary-lesions-treated-with-orbital-atherectomy
#17
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Richard A Shlofmitz
OBJECTIVES: We evaluated the clinical outcomes of patients with chronic kidney disease (CKD) who underwent orbital atherectomy for severe coronary artery calcification (CAC) prior to stent implantation. BACKGROUND: Percutaneous coronary intervention (PCI) of lesions with severe CAC is associated with increased rates of adverse clinical events. Patients with CKD are at increased risk for atherosclerotic cardiovascular disease, including vascular calcification, and have worse outcomes after PCI...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28045673/orbital-atherectomy-in-the-renal-artery-a-new-frontier-for-an-emerging-technology
#18
Javier A Valle, Ehrin J Armstrong, Stephen W Waldo
Orbital atherectomy has been developed as a method to modify calcified plaque in the peripheral vasculature, with extensive experience and data supporting its use in infrainguinal peripheral arterial disease. However, calcific atherosclerotic disease occurs in other vascular beds and may benefit from the application of this technology. In this case report, we describe the first reported use of orbital atherectomy in a renal artery. A 55-year-old male with severe drug-refractory hypertension was found to have renal artery stenosis, with severe calcification of the right renal artery...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28017543/cost-effectiveness-analysis-of-the-orbital-atherectomy-system-two-year-follow-up
#19
Louis P Garrison, Marita R Zimmermann, Christopher H Young, Janna Crittendon, Philippe Généreux
BACKGROUND: The presence of coronary artery calcification is associated with a significant burden of coronary artery disease along with being a predictor of increased adverse ischemic events. The Diamondback 360® Coronary Orbital Atherectomy System (OAS) is a novel device designed to facilitate treatment of calcified lesions. This study aimed to evaluate the cost-effectiveness of OAS compared to standard treatment. METHODS: A decision tree model utilizing ORBIT II clinical trial and Medicare data from the health system perspective was constructed...
March 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27974975/novel-use-of-an-orbital-atherectomy-device-for-in-stent-restenosis-lessons-learned
#20
K Shaikh, S Kelly, M Gedela, V Kumar, A Stys, T Stys
We present a case of a 67-year-old man with stage III chronic kidney disease, uncontrolled diabetes mellitus, coronary artery disease, and high surgical risk who presented with two episodes of acute coronary syndrome attributed to in-stent restenosis (ISR) associated with heavily calcified lesions. In this case, we were able to improve luminal patency with orbital atherectomy system (OAS); however, withdrawal of the device resulted in a device/stent interaction, causing failure of the device. Given limitations in current evidence and therapies, managing ISR can be a technical and cognitive challenge...
2016: Case Reports in Cardiology
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