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orbital atherectomy

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https://www.readbyqxmd.com/read/29197604/atherectomy-associated-complications-in-the-southern-california-vascular-outcomes-improvement-collaborative
#1
Yara Azar, Brian DeRubertis, Donald Baril, Karen Woo
INTRODUCTION: Atherectomy has become an increasingly utilized modality for the endovascular treatment of peripheral arterial occlusive disease. The objective of this study is to determine the incidence and risk factors for atherectomy-associated complications. METHODS: A retrospective review was performed of all atherectomy procedures performed between January 2011 and December 2015 in the Southern California Vascular Outcomes Improvement Collaborative. Atherectomy was defined as laser, orbital or excisional atherectomy...
November 29, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29179651/endovascular-therapy-of-the-superficial-femoral-artery-via-a-stand-alone-transradial-access-a-single-center-experience
#2
Elias B Hanna, Bashar A Ababneh, Amit N Amin
OBJECTIVE: We describe our experience in transradial recanalization of the superficial femoral artery (SFA), and we provide a stepwise approach accounting for the patient's height and optimizing the yield of currently available devices. METHODS AND RESULTS: Fifteen patients with simple SFA disease, including 4 patients with total SFA occlusions <15 cm, were selected for stand-alone transradial recanalization. A 6F, 125-cm multipurpose guiding catheter was used to cannulate the limb of interest and support device delivery...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29174822/acute-procedural-outcomes-of-orbital-atherectomy-for-the-treatment-of-iliac-artery-disease-sub-analysis-of-the-confirm-registries
#3
Michael S Lee, Brad J Martinsen, John Hollowed, Daniel Heikali, Jihad Mustapha, George Adams, Ehtisham Mahmud
Endovascular intervention is an appealing revascularization strategy for iliac artery disease. Atherectomy of the iliac artery is uncommon due to the risk of life-threatening perforation but may be necessary if the iliac lesion is heavily calcified, preventing stent delivery or optimal expansion. We assessed the feasibility and safety of orbital atherectomy for the treatment of iliac artery disease. Demographic data, lesion characteristics, and procedure outcomes for the CONFIRM patients with at least one iliac artery lesion treated with orbital atherectomy (n=62 patients; n=68 lesions) were compared to patients with at least one superficial femoral artery (SFA) lesion treated with orbital atherectomy (n=1570 patients; n=1809 lesions)...
October 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29117920/orbital-atherectomy-treatment-of-severely-calcified-native-coronary-lesions-in-patients-with-prior-coronary-artery-bypass-grafting-acute-and-one-year-outcomes-from-the-orbit-ii-trial
#4
Michael S Lee, Bynthia M Anose, Brad J Martinsen, Arthur C Lee, Richard A Shlofmitz, Jeffrey W Chambers
AIMS: Patients undergoing percutaneous coronary intervention (PCI), with a history of coronary artery bypass grafting (CABG), may be at increased risk for mortality and repeat revascularization, compared with patients without prior CABG. In this post-hoc analysis of the ORBIT II trial, safety and efficacy of coronary orbital atherectomy (OA) to modify severe coronary artery calcium, prior to stent placement, was evaluated in subjects based on history of CABG. METHODS AND RESULTS: Comorbidities: diabetes, dyslipidemia, hypertension, and history of myocardial infarction (MI) were more prevalent in the CABG group...
November 5, 2017: Cardiovascular Revascularization Medicine: Including Molecular 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/29072090/hospital-cost-impact-of-orbital-atherectomy-with-angioplasty-for-critical-limb-ischemia-treatment-a-modeling-approach
#6
Nicolas W Shammas, Christopher W Boyes, Swetha R Palli, John A Rizzo, Brad J Martinsen, Harry Kotlarz, J A Mustapha
AIM: The incremental cost of peripheral orbital atherectomy system (OAS) plus balloon angioplasty (BA) versus BA-only for critical limb ischemia was estimated. MATERIALS & METHODS: A deterministic simulation model used clinical and healthcare utilization data from the CALCIUM 360° trial and current cost data. Incremental cost of OAS + BA versus BA-only included differential utilization during the procedure and adverse-event costs at 3, 6 and 12-months. RESULTS: For every 100 procedures, incremental annual costs to the hospital were USD$350,930 lower with OAS + BA compared with BA-only...
October 26, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29045041/orbital-and-rotational-atherectomy-during-percutaneous-coronary-intervention-for-coronary-artery-calcification
#7
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/28974662/outcomes-of-patients-with-a-history-of-coronary-artery-bypass-grafting-who-underwent-orbital-atherectomy-for-severe-coronary-artery-calcification
#8
Michael S Lee, Evan Shlofmitz, Arash Nayeri, John Hollowed, Richard A Shlofmitz
OBJECTIVE: We assess the angiographic and clinical outcomes of patients with a history of coronary artery bypass graft (CABG) surgery who underwent orbital atherectomy for the treatment of severely calcified coronary lesions. BACKGROUND: The presence of severe coronary artery calcification (CAC) increases the complexity of percutaneous coronary intervention (PCI) and is associated with worse clinical outcomes. Patients with a history of CABG who undergo PCI often have comorbidities and are at higher risk for ischemic complications...
October 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28945162/orbital-atherectomy-for-the-treatment-of-severely-calcified-coronary-lesions-evidence-technique-and-best-practices
#9
Evan Shlofmitz, Brad J Martinsen, Michael Lee, Sunil V Rao, Philippe Généreux, Joe Higgins, Jeffrey W Chambers, Ajay J Kirtane, Emmanouil S Brilakis, David E Kandzari, Samin K Sharma, Richard Shlofmitz
The presence of severe coronary artery calcification is associated with higher rates of angiographic complications during percutaneous coronary intervention (PCI), as well as higher major adverse cardiac events compared with non-calcified lesions. Incorporating orbital atherectomy (OAS) for effective preparation of severely calcified lesions can help maximize the benefits of PCI by attaining maximal luminal gain (or stent expansion) and improve long-term outcomes (by reducing need for revascularization). Areas covered: In this manuscript, the prevalence, risk factors, and impact of coronary artery calcification on PCI are reviewed...
October 4, 2017: Expert Review of Medical Devices
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
#10
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/28870003/outcomes-of-patients-with-severely-calcified-aorto-ostial-coronary-lesions-who-underwent-orbital-atherectomy
#11
Michael S Lee, Evan Shlofmitz, Jeremy Kong, Pratyaksh K Srivastava, Saif Al Yaseen, Fernando A Sosa, Melissa Gallant, Richard Shlofmitz
OBJECTIVES: We assessed the feasibility and safety of orbital atherectomy in patients with severely calcified aorto-ostial coronary artery lesions. BACKGROUND: The treatment of calcified aorta-ostial coronary artery lesions is technically challenging. Orbital atherectomy can potentially damage the guiding catheter if it is not retracted sufficiently during treatment of ostial lesions. Orbital atherectomy can also excessively whip if the guiding catheter is not close enough to the ostium to provide sufficient support...
September 4, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28867375/calcified-plaque-modification-alters-local-drug-delivery-in-the-treatment-of-peripheral-atherosclerosis
#12
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/28733974/impact-of-diabetes-mellitus-on-procedural-and-one-year-clinical-outcomes-following-treatment-of-severely-calcified-coronary-lesions-with-the-orbital-atherectomy-system-a-subanalysis-of-the-orbit-ii-study
#13
Michael S Lee, Brad J Martinsen, Arthur C Lee, Ann N Behrens, Richard A Shlofmitz, Christopher Y Kim, Jeffrey W Chambers
OBJECTIVES: The goal of the study was to investigate the safety and efficacy of the coronary orbital atherectomy system to treat severe coronary artery calcification (CAC) prior to stent placement in diabetic and non-diabetic patients. BACKGROUND: The ORBIT II study reported the safety and efficacy of orbital atherectomy treatment in 443 patients with severe CAC. Percutaneous coronary intervention in diabetic patients is associated with an increased risk of major adverse cardiac events (MACE) compared with non-diabetics...
July 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28722196/safety-of-orbital-atherectomy-in-patients-with-left-ventricular-systolic-dysfunction
#14
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
#15
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
#16
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
#17
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
#18
MULTICENTER STUDY
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)...
August 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#19
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
#20
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
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