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orbital atherectomy

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https://www.readbyqxmd.com/read/29045041/orbital-and-rotational-atherectomy-during-percutaneous-coronary-intervention-for-coronary-artery-calcification
#1
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
#2
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
#3
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...
September 25, 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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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