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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28382804/optical-coherence-tomography-guided-therapy-of-instent-restenosis-for-peripheral-arterial-disease
#7
Michael K Lichtenberg, Jeffrey G Carr, Jaafer A Golzar
Approximately 27 million people in Europe and North America currently have peripheral arterial disease (PAD)1. The endovascular treatment of stenosis or blocked peripheral arteries in PAD include percutaneous transluminal angioplasty (PTA) with or without a drug coated balloon, 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 SFA lesions, and consequently increased their usage23...
April 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28368845/atherectomy-in-peripheral-artery-disease-a-review
#8
REVIEW
Tariq M Bhat, Maxwell E Afari, Lawrence A Garcia
Peripheral arterial disease (PAD) is a clinical manifestation of systemic atherosclerosis and is associated with significant morbidity and mortality. The physiological force and shear stress from angioplasty and stenting have made PAD treatment challenging. Atherectomy devices have continued to emerge as a major therapy in the management of peripheral vascular disease. This article presents a review of the current literature for the atherectomy devices used in PAD.
April 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28366300/distal-embolization-during-lower-extremity-endovascular-interventions
#9
Cassius I Ochoa Chaar, Fatma Shebl, Bauer Sumpio, Alan Dardik, Jeffrey Indes, Timur Sarac
OBJECTIVE: Distal embolization (DE) during peripheral arterial endovascular interventions is a well-known complication that is poorly studied. The goal of this study was to determine the incidence, risk factors, and effect of DE on the outcomes of lower extremity endovascular interventions (LEIs). METHODS: All LEIs between 2010 and 2014 in the Vascular Study Group of New England (VSGNE) database were reviewed. Patient characteristics were analyzed to determine predictors of DE...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28349710/endovascular-devices-and-revascularization-techniques-for-limb-threatening-ischemia-in-individuals-with-diabetes
#10
Jayer Chung
Diabetes mellitus (DM) is a rapidly worsening global epidemic over the last thirty-five years. The increased prevalence of DM has changed the phenotypic expression of atherosclerotic limb threatening ischemia (LTI), resulting in an increase in lesions in the tibial vessels. These patients are also afflicted with peripheral neuropathy, foot deformities, and medial calcification of the vasculature. In response to the evolving phenotype of atherosclerosis, newer minimally invasive tools and techniques have been developed to improve the blood supply in LTI...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28342839/a-case-of-severely-calcified-neoatherosclerosis-after-paclitaxel-eluting-stent-implantation
#11
Kei Yamamoto, Kenichi Sakakura, Yousuke Taniguchi, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
A 79-year-old male who had a history of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) received coronary angiography (CAG), because of angina pectoris. CAG showed in-stent restenosis of the paclitaxel-eluting stent (PES). Since the devices could not pass the lesion, we performed rotational atherectomy. Although we could not identify the calcified lesion by the optical frequency domain imaging (OFDI) findings because of strong attenuation, the intravascular ultrasound (IVUS) image showed the superficial calcification...
March 15, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28321242/aggressive-plaque-modification-with-rotational-atherectomy-and-cutting-balloon-for-optimal-stent-expansion-in-calcified-lesions
#12
Zhe Tang, Jing Bai, Shao-Ping Su, Pui-Wai Lee, Liang Peng, Tao Zhang, Ting Sun, Jing-Guo Nong, Tian-De Li, Yu Wang
OBJECTIVE: To evaluate the factors affecting optimal stent expansion in calcified lesions treated by aggressive plaque modification with rotational atherectomy (RA) and a cutting balloon (CB). METHODS: From January 2014 to May 2015, 92 patients with moderate to severe coronary calcified lesions underwent rotational atherectomy and intravascular ultrasound imaging at Chinese PLA General Hospital (Beijing, China) were included in this study. They were divided into a rotational artherectomy combined with cutting balloon (RACB) group (46 patients treated with RA followed by CB angioplasty) and an RA group (46 patients treated with RA followed by plain balloon angioplasty)...
December 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28314673/can-we-perform-rotational-atherectomy-in-patients-with-severe-aortic-stenosis-substudy-from-the-ocean-tavi-registry
#13
Toru Naganuma, Hiroyoshi Kawamoto, Kensuke Takagi, Hiroto Yabushita, Satoru Mitomo, Yusuke Watanabe, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Masanori Yamamoto, Hirokazu Onishi, Sunao Nakamura, Akihiro Higashimori, Minoru Tabata, Kazuki Mizutani, Hiroshi Ueno, Kentaro Hayashida
PURPOSE: The aim of this study was to report the safety of coronary rotational atherectomy (RA) in patients with severe aortic stenosis (AS). RA in the clinical setting seems challenging because coronary slow flow leads to hemodynamic instability. METHODS: Between October 2013 and May 2016, 1401 patients in the Optimized transCathEter vAlvular iNtervention (OCEAN) registry in Japan underwent transcatheter aortic valve implantation (TAVI). The primary study endpoint was procedural success, defined as residual stenosis <20% with final Thrombolysis in Myocardial Infarction flow 3...
February 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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
#14
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/28303645/zero-contrast-percutaneous-coronary-intervention-on-calcified-lesions-facilitated-by-rotational-atherectomy
#15
Keyvan Karimi Galougahi, Gary S Mintz, Dimitri Karmpaliotis, Ziad A Ali
Percutaneous coronary intervention (PCI) in patients with advanced chronic kidney disease (CKD) is challenging due to frequent presence of complex calcified lesions and the very high risk of contrast-induced nephropathy (CIN). We report a strategy of "zero contrast" PCI, guided by intravascular imaging and physiology, performed in three patients with advanced CKD in whom severe calcification necessitated rotational atherectomy (RA) to facilitate and optimize PCI. This approach resulted in safe and successful PCI while preserving renal function...
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/28287292/-long-term-results-after-invasive-treatment-of-critical-limb-ischemia
#17
Zoltán Ruzsa, Ferenc Kuti, Balázs Berta, Károly Tóth, Zoltán Bánsághi, Zoltán Vámosi, Kálmán Hüttl
INTRODUCTION AND AIM: Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. METHOD: The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28274573/in-hospital-and-1-year-outcomes-of-rotational-atherectomy-and-stent-implantation-in-patients-with-severely-calcified-unprotected-left-main-narrowings-from-the-multicenter-rotate-registry
#18
Alfonso Ielasi, Hiroyoshi Kawamoto, Azeem Latib, Giacomo G Boccuzzi, Gennaro Sardella, Roberto Garbo, Emanuele Meliga, Fabrizio D'Ascenzo, Patrizia Presbitero, Sunao Nakamura, Antonio Colombo
Heavily calcified unprotected left main (ULM) disease continues to be a challenging situation and represent a high-risk subset for interventional cardiologist. To date, there are limited data investigating the results after rotational atherectomy (RA) in this setting. The aim of this study was to investigate the in-hospital and 1-year outcomes after RA of heavily calcified ULM lesions. A retrospective cohort analysis was performed on all calcified patients with ULM (n = 86) enrolled in the multicenter international ROTATE registry (overall patients, n = 962)...
February 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28258729/comparison-of-rotational-atherectomy-versus-orbital-atherectomy-for-the-treatment-of-heavily-calcified-coronary-plaques
#19
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...
February 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28257771/current-role-of-atherectomy-for-treatment-of-femoropopliteal-and-infrapopliteal-disease
#20
REVIEW
Nicolas W Shammas
Atherectomy improves the acute procedural success of a procedure whether treating de novo or restenotic (including in-stent) disease. Intermediate follow-up results seem to be in favor of atherectomy in delaying and reducing the need for repeat revascularization in patients with femoropopliteal in-stent restenosis. Recent data suggest that avoiding cutting into the external elastic lamina is an important factor in reducing restenosis. The interplay between directional atherectomy and drug-coated balloons is unclear...
April 2017: Interventional cardiology clinics
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