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https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#1
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/28508349/the-contemporary-role-of-stents-and-angioplasty-for-the-treatment-of-infrapopliteal-disease-in-critical-limb-ischemia
#2
REVIEW
Tarek A Hammad, Anand Prasad
PURPOSE OF REVIEW: Critical limb ischemia (CLI) is associated with significant morbidity, mortality, and increased health care expenses. Revascularization has a central role in the treatment of CLI. Following publication of BASIL (bypass versus angioplasty in severe ischemia of the leg) trial a decade ago, an "endovascular first" approach had gained momentum and the technologies available for endovascular therapy have exponentially increased. Both the development of technology and technique, highlighted in this review, have allowed operators to treat complex infrapopliteal lesions which are central to CLI pathology...
July 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28500242/rotational-atherectomy-re-emergence-of-an-old-technique
#3
Adam J de Belder
No abstract text is available yet for this article.
May 12, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28499595/impact-of-calcium-on-chronic-total-occlusion-percutaneous-coronary-interventions
#4
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, William Lombardi, Michael R Wyman, Anthony Doing, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, David Kandzari, Nicholas Lembo, Santiago Garcia, Barbara A Danek, Aris Karatasakis, Erica Resendes, Pratik Kalsaria, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
We sought to examine the impact of calcific deposits on the outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). The outcomes of 1,476 consecutive CTO PCIs performed in 1,453 patients (65.5 ± 10 years, 85% male) between 2012 and 2016 at 11 US centers were evaluated. Moderate or severe quantity of calcium was present in 58% of target lesions. Calcified lesions were more tortuous and more likely to have proximal cap ambiguity and interventional collaterals. PCI of moderately/severely calcified CTOs more often required use of the retrograde approach (54% vs 30%, p <0...
April 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28488406/between-a-rock-and-a-hard-place-adventures-in-treating-calcific-femoropopliteal-disease
#5
EDITORIAL
Richard Heuser
SFA disease has unique challenges A myriad of interventional techniques have been proposed to treat calcific femoral disease It appears a combination of atherectomy and drug elution may be the procedure of choice in these patients New innovative therapies may be a viable option in the future.
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28486842/impact-of-angioscopic-evaluation-for-femoropopliteal-in-stent-restenosis-before-and-after-excimer-laser-atherectomy
#6
Akiko Idemoto, Naotaka Okamoto, Akihiro Tanaka, Naoki Mori, Daisuke Nakamura, Masamichi Yano, Nobuhiko Makino, Yasuyuki Egami, Ryu Shutta, Jun Tanouchi, Masami Nishino
In-stent restenosis (ISR) is a prevalent problem following stenting of femoropopliteal lesions. A potential novel treatment modality for ISR including excimer laser atherectomy (ELA) has become available. We performed ELA for in-stent chronic total occlusion (CTO) of femoropopliteal lesions and evaluated lesion morphology before and after ELA by angioscopy in 2 patients. The angioscopic findings clearly showed removal of in-stent thrombi after ELA. Thus, ELA may be effective for in-stent CTO of femoropopliteal lesions...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28480081/peeled-guidewire-coating-with-debulked-plaque-obtained-by-directional-coronary-atherectomy
#7
Rikuta Hamaya, Taishi Yonetsu, Sadamitsu Ichijo, Makoto Araki, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Junji Matsuda, Masahiro Hoshino, Masahiro Hada, Takayuki Niida, Yoshinori Kanno, Tsunekazu Kakuta
Percutaneous directional coronary atherectomy (DCA) is a plaque debulking method performed in Japan, and recently a renewed DCA device has been launched. We present a case with a tight left anterior descending lesion undergoing percutaneous coronary intervention with application of DCA. After several sessions of DCA, white plaques accompanied by green, stringed materials were obtained from the device; some materials were considerably long (approximately 15 mm in length). A drug-eluting stent was subsequently implanted, and the procedure was completed successfully without any complications...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28479446/laser-atherectomy-for-the-treatment-of-peripheral-arterial-disease
#8
Alexandros Mallios, John Blebea, Bryan Buster, Ryan Messiner, Kevin Taubman, Harry Ma
OBJECTIVE: To investigate the clinical results of laser atherectomy in the treatment of peripheral arterial disease. METHODS: Retrospective analysis of consecutive patients undergoing laser atherectomy at a single institution during a seven year period by vascular surgeons and interventional cardiologists in a tertiary university-affiliated hospital. Clinical data was retrieved from patient charts and hospital electronic medical records along with the associated arteriograms...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28472949/distinct-gene-expression-profiles-associated-with-notch-ligands-delta-like-4-and-jagged1-in-plaque-material-from-peripheral-artery-disease-patients-a-pilot-study
#9
Giorgio Aquila, Cinzia Fortini, Antonio Pannuti, Serena Delbue, Micaela Pannella, Marco Bruno Morelli, Cristiana Caliceti, Fausto Castriota, Monica de Mattei, Alessia Ongaro, Agnese Pellati, Pasquale Ferrante, Lucio Miele, Luigi Tavazzi, Roberto Ferrari, Paola Rizzo, Alberto Cremonesi
BACKGROUND: The lack of early diagnosis, progression markers and effective pharmacological treatment has dramatic unfavourable effects on clinical outcomes in patients with peripheral artery disease (PAD). Addressing these issues will require dissecting the molecular mechanisms underlying this disease. We sought to characterize the Notch signaling and atherosclerosis relevant markers in lesions from femoral arteries of symptomatic PAD patients. METHODS: Plaque material from the common femoral, superficial femoral or popliteal arteries of 20 patients was removed by directional atherectomy...
May 4, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28472818/excimer-laser-facilitated-coronary-angioplasty-of-a-heavy-calcified-lesion-treated-with-bioresorbable-scaffolds
#10
Antonio Mangieri, Richard J Jabbour, Akihito Tanaka, Andrea Aurelio, Antonio Colombo, Azeem Latib
: Excimer coronary laser atherectomy (ECLA) has been shown to be both well tolerated and effective for plaque modification. Its technology is based on ultraviolet energy and is capable of disintegrating atheroma, without burning or grossly fragmenting it. ELCA has proven effective in the percutaneous treatment of a variety of complex lesions. Here we present a case of multiple heavy calcified lesions successfully prepared with ELCA and finally treated with the implantation of multiple bioresorbable scaffolds...
December 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28451812/debulking-atherectomy-in-the-peripheral-arteries-is-there-a-role-and-what-is-the-evidence
#11
Konstantinos Katsanos, Stavros Spiliopoulos, Lazaros Reppas, Dimitris Karnabatidis
Traditional percutaneous balloon angioplasty and stent placement is based on mechanical plaque disruption and displacement within the arterial wall. On the contrary, transcatheter atherectomy achieves atherosclerotic plaque clearance by means of directional plaque excision or rotational plaque removal or laser plaque ablation. Debulking atherectomy may allow for a more uniform angioplasty result at lower pressures with consequently less vessel barotrauma and improved luminal gain, thereby decreasing the risk of plaque recoil and dissection that may require permanent metal stenting...
April 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28450676/predictors-of-recurrent-in-stent-restenosis-after-paclitaxel-coated-balloon-angioplasty
#12
Hiroshi Koiwaya, Nozomi Watanabe, Nehiro Kuriyama, Shun Nishino, Kenji Ogata, Toshiyuki Kimura, Tatsuya Nakama, Hirohide Matsuura, Makoto Furugen, Yoshisato Shibata
BACKGROUND: Although paclitaxel-coated balloon (PCB) angioplasty is an effective procedure for in-stent restenosis (ISR) after coronary stenting, recurrent ISR after PCB angioplasty still occurs. The aim of this study was to evaluate the predictors of recurrent ISR after PCB angioplasty for ISR.Methods and Results:A total of 157 ISR lesions treated with PCB angioplasty from January 2014 to May 2015 were retrospectively examined. Recurrent ISR was judged on 6-month follow-up angiography...
April 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28441644/management-of-guidewire-entrapment-with-laser-atherectomy
#13
Judit Karacsonyi, Jose R Martinez-Parachini, Barbara A Danek, Aris Karatasakis, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis
A 62-year-old man was referred for percutaneous coronary intervention of a severe circumflex lesion. The guidewire became entangled in the previously implanted left anterior descending artery stent. The left main was engaged with a second guide catheter, followed by balloon dilations, various microcatheters, and laser atherectomy. The wire eventually fractured without protruding into the aorta. The circumflex lesion was stented with two stents, followed by left main stenting that covered the fragment. Caution should be used when wiring through stents; wire fracture can be treated with stent implantation, as long as the wire fragment does not protrude into the aorta...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28433335/treatment-of-peripheral-arterial-disease-via-percutaneous-brachial-artery-access
#14
Randall W Franz, Christopher F Tanga, Joseph W Herrmann
OBJECTIVE: This review was conducted to evaluate the types of endovascular procedures that can be performed via brachial artery access, evaluate the access success rate, and determine the incidence of technical complications. METHODS: A retrospective 10-year record review at a tertiary facility from January 1, 2005, through June 30, 2015, was completed. Patients who underwent attempted brachial artery access were eligible for review. Outcomes intended to be evaluated included ability to access the vessel, reach an identified lesion, and perform an indicated procedure, while describing the incidence and type of complications that occurred to clarify the utility and safety of brachial artery access...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28424222/randomized-comparison-of-paclitaxel-eluting-balloon-angioplasty-plus-stenting-versus-standard-balloon-angioplasty-plus-stenting-versus-directional-atherectomy-for-symptomatic-femoral-artery-disease-isar-stath
#15
Ilka Ott, Salvatore Cassese, Philipp Groha, Birgit Steppich, Martin Hadamitzky, Tareq Ibrahim, Sebastian Kufner, Karl Dewitz, Regina V Hiendlmayer, Karl-Ludwig Laugwitz, Heribert Schunkert, Adnan Kastrati, Massimiliano Fusaro
Background -Atherosclerosis in the superficial femoral artery (SFA) is common in patients suffering from peripheral artery disease. Paclitaxel-eluting balloon (PEB) angioplasty, stenting and directional atherectomy (DA) have provided new options for the treatment of SFA disease, however the comparative efficacy remains uncertain. Methods -One hundred and fifty five patients with symptomatic peripheral artery disease with de novo SFA stenotic or occlusive lesions were randomized to treatment with plain balloon angioplasty (BA) followed by PEB angioplasty and stenting (n=48), BA followed by stenting (n=52) or directional DA with distal protection and bailout stenting (n=55)...
April 19, 2017: Circulation
https://www.readbyqxmd.com/read/28419791/the-role-of-rotational-atherectomy-in-contemporary-chronic-total-occlusion-percutaneous-coronary-intervention
#16
EDITORIAL
Yader Sandoval, Emmanouil S Brilakis
Rotational atherectomy is performed infrequently (∼3.5%) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI) for two indications: treatment of balloon uncrossable and balloon undilatable lesions. Use of rotational atherectomy in CTO PCI was associated with high success and acceptable complication rates. Rotational atherectomy remains a "must have" device for interventional cardiologists performing complex PCI.
April 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28417613/combination-therapy-for-complex-peripheral-artery-disease-the-evidence-for-combining-mechanical-revascularisation-with-anti-restenotic-drug-delivery-systems
#17
Ramon L Varcoe
The management of complex, lower-extremity peripheral artery disease remains a difficult challenge, with ample room for improvement in the results seen with current generation devices. Therapies which use a combination of multiple devices for their mechanical and anti-restenotic properties may be advantageous, and offer an opportunity to improve the durability of revascularization through optimizing and individualizing care. Combination therapy typically utilizes drug delivery devices in addition to stents and atherectomy to achieve improved results...
April 14, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28417604/rotational-atherectomy-in-the-subadventitial-space-to-allow-safe-and-successful-chronic-total-occlusion-recanalization-pushing-the-limit-further
#18
Giuliana Capretti, Mauro Carlino, Antonio Colombo, Lorenzo Azzalini
Dissection and re-entry (DR) techniques have played a key role in the increase of success rates of chronic total occlusion (CTO) recanalization. DR usually allows wiring complex occlusions, even in case of important calcification. In extreme cases, such as in balloon failure-to-cross, rotational atherectomy (RA) might be decisive. However, according to experts' recommendations, RA should not be performed in dissection planes because of the high risk of perforation and further extending the dissection, so that its use after DR might be limited...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28398398/-new-technologies-and-applications-for-drug-coated-balloons
#19
Bernardo Cortese, Gaetano Di Palma, Roberto Nerla, Antonio Micari
Drug-eluting stents (DES) represent nowadays the gold standard treatment for coronary artery disease. Despite the safety and efficacy, and favorable long-term clinical outcomes of new generation DES, their use is still associated with a not negligible risk of long-term events, related to the presence of a definitive prosthesis in the vessel wall. In addition, DES implantation is not always desirable in particular anatomic settings (small vessels, bifurcations) or in patients with higher bleeding risk. In recent years, drug-coated balloons (DCB) have been developed to overcome some of these limitations, offering a combined mechanical (balloon dilation) and biological therapy (drug-release)...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28393673/lower-extremity-revascularization-using-optical-coherence-tomography-guided-directional-atherectomy-final-results-of-the-evaluation-of-the-pantheris-optical-coherence-tomography-imaging-atherectomy-system-for-use-in-the-peripheral-vasculature-vision-study
#20
Arne G Schwindt, J Gray Bennett, William H Crowder, Suhail Dohad, Sean F Janzer, Jon C George, Barry Tedder, Thomas P Davis, Ian M Cawich, Roger S Gammon, Patrick E Muck, John P Pigott, Dwight A Dishmon, Lou A Lopez, Jaafer A Golzar, Jack R Chamberlin, Michael J Moulton, Ramzan M Zakir, Amir K Kaki, Gary J Fishbein, Huey B McDaniel, Ayala Hezi-Yamit, John B Simpson, Arjun Desai
PURPOSE: To evaluate the safety and efficacy of a novel optical coherence tomography (OCT)-guided atherectomy catheter in treating patients with symptomatic femoropopliteal disease. METHODS: The VISION trial ( ClinicalTrials.gov identifier NCT01937351) was a single-arm, multicenter, global investigational device exemption study enrolling 158 subjects (mean age 67.2±10.5 years; 87 men) across 20 participating sites. In this cohort, 198 lesions were treated with an average length of 53±40 mm using the Pantheris catheter alone or Pantheris + adjunctive therapy...
April 1, 2017: Journal of Endovascular Therapy
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