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orbital atherectomy

Yohei Sotomi, Rafael Cavalcante, Richard A Shlofmitz, Pannipa Suwannasom, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zheng, Mohammad Abdelghani, Robbert J de Winter, Joanna J Wykrzykowska, Yoshinobu Onuma, Patrick W Serruys
AIMS: Recently, favourable procedural 30-day and one-year outcomes with the Diamondback 360 Orbital Atherectomy System (OAS) in the treatment of severely calcified lesions have been reported. The purpose of this study was to assess the therapeutic mechanism and efficacy of the OAS with optical coherence tomography (OCT) imaging. METHODS AND RESULTS: This was an observational imaging study in 18 patients with complex calcified coro-nary artery lesions who underwent percutaneous coronary intervention with the OAS...
October 20, 2016: EuroIntervention
Ron Waksman, Hector M Garcia-Garcia
No abstract text is available yet for this article.
October 20, 2016: EuroIntervention
Michael S Lee, Arthur C Lee, Richard A Shlofmitz, Brad J Martinsen, Nick J Hargus, Mahir D Elder, Philippe Généreux, Jeffrey W Chambers
OBJECTIVES: To investigate the safety and efficacy of the coronary Orbital Atherectomy System (OAS) to prepare severely calcified lesions for stent deployment in patients grouped by renal function. BACKGROUND: Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with increased rates of major adverse cardiac events (MACE), including death, myocardial infarction (MI), and target vessel revascularization (TVR) compared with PCI of non-calcified vessels...
August 27, 2016: Catheterization and Cardiovascular Interventions
Michael S Lee, Evan Shlofmitz, Heajung Nguyen, Richard A Shlofmitz
OBJECTIVES: We evaluated the angiographic and clinical outcomes of orbital atherectomy to treat severely calcified coronary lesions in diabetic and non-diabetic patients. BACKGROUND: Diabetics have increased risk for death, myocardial infarction, and target vessel revascularization after percutaneous coronary intervention. Severely calcified coronary lesions are associated with increased cardiac events. Orbital atherectomy facilitates stent delivery and optimizes stent expansion by modifying severely calcified plaque...
October 2016: Journal of Interventional Cardiology
Shriti M Mehta, Paul M Johnson, Joel E Schneider
No abstract text is available yet for this article.
October 10, 2016: JACC. Cardiovascular Interventions
Michele Richard, Emilia Krol, Alan Dietzek
PURPOSE: To describe the use of orbital technique of atherectomy as an adjunct to successful angioplasty and stent placement of the superior mesenteric artery (SMA). TECHNIQUE: The technique is demonstrated in a 68-year-old male with critical SMA stenosis. The SMA was cannulated with 0.014 wire, but the lesion was highly stenotic and densely calcified and prevented the passage of even the smallest 1.5mm balloon. Orbital atherectomy was thus performed with a 1.25mm CSI crown...
July 14, 2016: Annals of Vascular Surgery
Sreekumar Madassery, Ulku C Turba, Bulent Arslan
Peripheral vascular disease (PVD) is a devastating medical problem that may lead to significant life alterations for patients, from simply limiting their daily activities to potential loss of limbs and eventual demise. Superficial femoral and popliteal arteries are significantly common locations for PVD sequelae to present itself, and owing to their length and mobile nature, treatment of these segments are quite challenging. Indications for PVD treatment include lifestyle-limiting claudication that is not responding to medical management, ischemic rest pain, nonhealing ulcers, and lower extremity gangrene...
June 2016: Techniques in Vascular and Interventional Radiology
Michael S Lee, Evan Shlofmitz, Barry Kaplan, Dragos Alexandru, Perwaiz Meraj, Richard Shlofmitz
OBJECTIVES: We evaluated the safety and efficacy of orbital atherectomy in real-world patients with severe coronary artery calcification (CAC). BACKGROUND: The presence of severe CAC increases the complexity of percutaneous coronary intervention as it may impede stent delivery and optimal stent expansion. Atherectomy may be an indispensable tool for uncrossable or undilatable lesions by modifying severe CAC. Although the ORBIT I and II trials report that orbital atherectomy was safe and effective for the treatment of severe CAC, patients with kidney disease, recent myocardial infarction, long diffuse disease, severe left ventricular dysfunction, and unprotected left main disease were excluded...
August 2016: Journal of Interventional Cardiology
Brian D Plourde, Lauren J Vallez, Biyuan Sun, Brittany B Nelson-Cheeseman, John P Abraham, Cezar S Staniloae
Simulations were made of the pressure and velocity fields throughout an artery before and after removal of plaque using orbital atherectomy plus adjunctive balloon angioplasty or stenting. The calculations were carried out with an unsteady computational fluid dynamic solver that allows the fluid to naturally transition to turbulence. The results of the atherectomy procedure leads to an increased flow through the stenotic zone with a coincident decrease in pressure drop across the stenosis. The measured effect of atherectomy and adjunctive treatment showed decrease the systolic pressure drop by a factor of 2...
September 2016: Cardiovascular Engineering and Technology
Yihao Zheng, Barry Belmont, Albert J Shih
Orbital atherectomy is a catheter-based minimally invasive procedure to modify the plaque within atherosclerotic arteries using a diamond abrasive crown. This study was designed to investigate the crown motion and its corresponding contact force with the vessel. To this end, a transparent arterial tissue-mimicking phantom made of polyvinyl chloride was developed, a high-speed camera and image processing technique were utilized to visualize and quantitatively analyze the crown motion in the vessel phantom, and a piezoelectric dynamometer measured the forces on the phantom during the procedure...
July 2016: Medical Engineering & Physics
Philippe Généreux, Nicolas Bettinger, Björn Redfors, Arthur C Lee, Christopher Y Kim, Michael S Lee, Richard A Shlofmitz, Jeffrey W Moses, Gregg W Stone, Jeff W Chambers
OBJECTIVES: We report 2-year outcomes of the Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions (ORBIT II) trial, with emphasis on the impact of stent type. BACKGROUND: The ORBIT II trial demonstrated the safety and efficacy of the Diamondback 360° Coronary Orbital Atherectomy System (OAS; Cardiovascular Systems, Inc., St. Paul, MN) in the treatment of de novo, severely calcified coronary lesions. METHODS: ORBIT II was a single-arm trial that enrolled 443 subjects with severely calcified lesions at 49 US sites...
September 2016: Catheterization and Cardiovascular Interventions
Bill D Gogas, Boyi Yang, Marina Piccinelli, Yasir H Bouchi, Spencer B King, Nabil Dib, Don P Giddens, Alessandro Veneziani, Habib Samady
No abstract text is available yet for this article.
April 11, 2016: JACC. Cardiovascular Interventions
Michael S Lee, Evan Shlofmitz, Barry Kaplan, Richard Shlofmitz
OBJECTIVE: We report the clinical outcomes of patients who underwent percutaneous coronary intervention (PCI) with orbital atherectomy for severely calcified unprotected left main coronary artery (ULMCA) disease. BACKGROUND: Although surgical revascularization is the gold standard for patients with ULMCA disease, not all patients are candidates for this. PCI is increasingly used to treat complex coronary artery disease, including ULMCA disease. The presence of severely calcified lesions increases the complexity of PCI...
April 2016: Journal of Invasive Cardiology
Jaya Chandrasekhar, Roxana Mehran
Calcified lesions are associated with lower rates of successful percutaneous coronary intervention (PCI), greater stent thrombosis, and increased target vessel revascularization. Women undergoing PCI are more often older than men and likely to present with severe lesion calcification. The ORBIT II study, for the first time compares the effect of the orbital atherectomy system (OAS) in men and women undergoing PCI for severely calcified lesions. Although the adjusted risk of severe dissections was higher in women, the incidence of in-hospital and 30-day outcomes was similar to men...
March 2016: Catheterization and Cardiovascular Interventions
Michael S Lee, Evan Shlofmitz, Richard Shlofmitz, Sheila Sahni, Brad Martinsen, Jeffrey Chambers
OBJECTIVES: The ORBIT II trial reported excellent outcomes in patients with severely calcified coronary lesions treated with orbital atherectomy. Severe calcification of the left main (LM) artery represents a complex coronary lesion subset. This study evaluated the safety and efficacy of coronary orbital atherectomy to prepare severely calcified protected LM artery lesions for stent placement. METHODS: The ORBIT II trial was a prospective, multicenter clinical trial that enrolled 443 patients with severely calcified coronary lesions in the United States...
September 2016: Journal of Invasive Cardiology
Matthew I Tomey, Samin K Sharma
Coronary artery calcification is an integral process in atherogenesis. When it is moderate or severe, coronary artery calcification presents several challenges to percutaneous coronary intervention. Historically, these difficulties have caused percutaneous coronary intervention of calcified lesions to be associated with lower rates of procedural success, higher rates of angiographic complications, and higher rates of subsequent adverse cardiovascular events. With growth of technologies and maturation of technique for atheroablation, in particular rotational atherectomy and orbital atherectomy, percutaneous coronary intervention of calcified coronary lesions has become possible with an extremely high success rate and a favorable safety profile...
February 2016: Current Cardiology Reports
Inyong Hwang, Kavita Bomb, Raza Askari, Rami N Khouzam
Spontaneous arteriovenous fistulas are a rare clinical entity with very few cases reported in the literature. Prompt diagnosis and treatment is crucial and can prevent further complications in such patients. We report a case of a patient who presented with progressive bilateral claudication, discolouration of feet, hypaesthesia and non-healing ulcers. The patient had no history of trauma, aneurysm or surgery. After abnormal non-invasive studies, a peripheral angiogram revealed significant disease and obstruction of bilateral superficial femoral arteries...
2016: BMJ Case Reports
Jeffrey Chambers, Philippe Généreux, Arthur Lee, Jack Lewin, Christopher Young, Janna Crittendon, Marita Mann, Louis P Garrison
BACKGROUND: Patients who undergo percutaneous coronary intervention (PCI) for severely calcified coronary lesions have long been known to have worse clinical and economic outcomes than patients with no or mildly calcified lesions. We sought to assess the likely cost-effectiveness of using the Diamondback 360(®) Orbital Atherectomy System (OAS) in the treatment of de novo, severely calcified lesions from a health-system perspective. METHODS AND RESULTS: In the absence of a head-to-head trial and long-term follow up, cost-effectiveness was based on a modeled synthesis of clinical and economic data...
April 2016: Therapeutic Advances in Cardiovascular Disease
Michael S Lee, Jihad Mustapha, Robert Beasley, Paramjit Chopra, Tony Das, George L Adams
OBJECTIVES: This analysis compares the procedural and acute angiographic outcomes in patients with critical limb ischemia (CLI) treated with orbital atherectomy in above-the-knee (ATK)/popliteal (POP) lesions versus below-the-knee (BTK) lesions. BACKGROUND: Lesion location affects the procedural outcomes and the opportunity for limb salvage in patients with CLI suffering from peripheral artery disease (PAD). METHODS: The CONFIRM registry series was analyzed and includes 1109 real-world patients (1544 lesions) suffering from CLI treated with orbital atherectomy...
February 15, 2016: Catheterization and Cardiovascular Interventions
B J Martinsen, S A Weber, M L Pietzsch, A Behrens, M Weatherspoon, Z Igyarto, R Zhao, H Kotlarz, J B Pietzsch
No abstract text is available yet for this article.
November 2015: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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