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orbital atherectomy

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https://www.readbyqxmd.com/read/29610442/multicenter-registry-of-real-world-patients-with-severely-calcified-coronary-lesions-undergoing-orbital-atherectomy-1-year-outcomes
#1
Michael S Lee, Evan Shlofmitz, Alec Goldberg, Richard Shlofmitz
OBJECTIVES: We report the 1-year outcomes of real-world patients with severely calcified coronary arteries who underwent orbital atherectomy. BACKGROUND: Percutaneous coronary intervention of heavily calcified lesions is technically challenging and associated with worse clinical outcomes. Modification of severely calcified coronary lesions with orbital atherectomy facilitates stent delivery and expansion. Although we previously reported the safety of orbital atherectomy at 30 days in all comers with severely calcified coronary lesions, including patients who were excluded from the ORBIT II trial, longer-term follow-up is unknown...
April 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29575766/pseudoaneurysm-of-the-left-main-coronary-artery-a-complication-of-orbital-atherectomy
#2
Luis F Tapias, Joseph Campbell, Kenneth Rosenfield, David A D'Alessandro
Plaque modification devices are used to treat heavily calcified coronary artery lesions during percutaneous coronary artery interventions. As these devices have unique risk profiles, clinicians need to be aware of potential complications associated with their use. A case of a contained rupture (i.e., pseudoaneurysm) of the proximal left main coronary artery following orbital atherectomy is presented. This lesion was managed with coronary artery bypass grafting and oversewing of the left main coronary artery ostium...
March 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29521479/robotically-performed-excimer-laser-coronary-atherectomy-proof-of-feasibility
#3
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
https://www.readbyqxmd.com/read/29454531/orbital-atherectomy-for-the-treatment-of-small-2-5mm-severely-calcified-coronary-lesions-orbit-ii-sub-analysis
#4
Michael S Lee, Richard A Shlofmitz, Evan Shlofmitz, Pratyaksh K Srivastava, Jeremy Kong, Cindy Grines, George Revytak, Jeffrey W Chambers
OBJECTIVES: We assessed the safety and efficacy of orbital atherectomy to modify severely calcified coronary plaque prior to stent implantation in patients with small vessel (2.5mm) disease. BACKGROUND: Severe coronary artery calcification increases the risk of adverse clinical events during percutaneous coronary intervention (PCI). Patients who undergo PCI of small vessels have worse clinical outcomes including higher rates of perforation and dissection. The outcomes of orbital atherectomy of small diameter vessels (2...
October 3, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29452841/impact-of-age-following-treatment-of-severely-calcified-coronary-lesions-with-the-orbital-atherectomy-system-3-year-follow-up
#5
Michael S Lee, Richard A Shlofmitz, Brad J Martinsen, Sanjum Sethi, Jeffrey W Chambers
OBJECTIVES: We investigated the safety and efficacy of coronary orbital atherectomy to treat severely calcified lesions prior to stenting based upon age. BACKGROUND: The ORBIT II study reported the safety and efficacy with orbital atherectomy in 443 patients with severely calcified lesions. Elderly patients undergoing percutaneous coronary intervention may be at increased risk for major adverse cardiac events (MACE) and death compared with younger patients. METHODS: Patients were stratified according to age (≥75 year old [174/443, 39...
January 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29452688/comparison-of-the-efficacy-and-safety-of-orbital-and-rotational-atherectomy-in-calcified-narrowings-in-patients-who-underwent-percutaneous-coronary-intervention
#6
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
https://www.readbyqxmd.com/read/29440624/aminophylline-for-preventing-bradyarrhythmias-during-orbital-or-rotational-atherectomy-of-the-right-coronary-artery
#7
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
https://www.readbyqxmd.com/read/29430783/editorial-orbital-atherectomy-a-portal-opens
#8
EDITORIAL
Stewart M Benton, Gautam Kumar
No abstract text is available yet for this article.
February 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29378972/impact-of-the-use-of-intravascular-imaging-on-patients-who-underwent-orbital-atherectomy
#9
Michael S Lee, Evan Shlofmitz, Jeremy Kong, Gentian Lluri, Pratyaksh K Srivastava, Richard Shlofmitz
OBJECTIVES: We assessed the impact of intravascular ultrasound (IVUS)/optical coherence tomography (OCT) on outcomes of patients who underwent orbital atherectomy. BACKGROUND: Intravascular imaging provides enhanced lesion morphology assessment and optimization of percutaneous coronary intervention (PCI) outcomes. Severe coronary artery calcification increases the complexity of PCI and is associated with worse clinical outcomes. Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
February 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29368259/computational-fluid-dynamics-modeling-of-the-burr-orbital-motion-in-rotational-atherectomy-with-particle-image-velocimetry-validation
#10
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
https://www.readbyqxmd.com/read/29245154/acute-procedural-outcomes-of-orbital-atherectomy-for-the-treatment-of-profunda-femoris-artery-disease-subanalysis-of-the-confirm-registries
#11
Michael S Lee, Pratyaksh K Srivastava, Saif Al Yaseen, Daniel Heikali, John Hollowed, Ehtisham Mahmud
OBJECTIVES: We compared the angiographic outcomes of patients treated with orbital atherectomy for profunda femoris artery (PFA) and superficial femoral artery (SFA) disease from the CONFIRM I-III registries. BACKGROUND: Endovascular revascularization of the PFA is considered a high-risk procedure given that it is an important collateral vessel when the SFA becomes occluded. Data on outcomes of endovascular revascularization of calcified PFA disease are limited...
December 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29197604/atherectomy-associated-complications-in-the-southern-california-vascular-outcomes-improvement-collaborative
#12
Yara Azar, Brian DeRubertis, Donald Baril, Karen Woo
BACKGROUND: Atherectomy has become an increasingly utilized modality for the endovascular treatment of peripheral arterial occlusive disease. The objective of this study was to determine the incidence and risk factors for atherectomy-associated complications. METHODS: A retrospective review was performed for 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
#13
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...
February 2018: 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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