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https://www.readbyqxmd.com/read/28931790/clinical-characteristics-and-long-term-outcomes-of-rotational-atherectomy%C3%A3-j2t-multicenter-registry
#1
Iwao Okai, Tomotaka Dohi, Shinya Okazaki, Kentaro Jujo, Makoto Nakashima, Hisao Otsuki, Kazuki Tanaka, Hiroyuki Arashi, Ryuta Okabe, Fukuko Nagura, Yugo Nara, Hiroshi Tamura, Takeshi Kurata, Hideyuki Kawashima, Hiroyuki Kyono, Junichi Yamaguchi, Katsumi Miyauchi, Ken Kozuma, Nobuhisa Hagiwara, Hiroyuki Daida
BACKGROUND: Rotational atherectomy (RA) is an adjunct tool for the management of heavily calcified coronary lesions during percutaneous coronary intervention (PCI), but the long-term clinical outcomes of RA use remain unclear in this drug-eluting stent era.Methods and Results:This multi-center registry assessed the characteristics and outcomes of patients treated by RA for calcified coronary lesions between 2004 and 2015. Among 1,090 registered patients, mean age was 70±10 years and 815 (75%) were male...
September 21, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28916604/coronary-perforation-complicating-percutaneous-coronary-intervention-in-patients-with-a-history-of-coronary-artery-bypass-surgery-an-analysis-of-309-perforation-cases-from-the-british-cardiovascular-intervention-society-database
#2
Tim Kinnaird, Richard Anderson, Nick Ossei-Gerning, James Cockburn, Alex Sirker, Peter Ludman, Mark de Belder, Thomas W Johnson, Samuel Copt, Azfar Zaman, Mamas A Mamas
BACKGROUND: The evidence base for coronary perforation (CP) occurring during percutaneous coronary intervention in patients with a history of coronary artery bypass surgery (PCI-CABG) is limited and the long-term effects unclear. Using a national PCI database, the incidence, predictors, and outcomes of CP during PCI-CABG were defined. METHODS AND RESULTS: Data were analyzed on all PCI-CABG procedures performed in England and Wales between 2005 and 2013. Multivariate logistic regressions and propensity scores were used to identify predictors of CP and its association with outcomes...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28916599/directional-atherectomy-followed-by-a-paclitaxel-coated-balloon-to-inhibit-restenosis-and-maintain-vessel-patency-twelve-month-results-of-the-definitive-ar-study
#3
Thomas Zeller, Ralf Langhoff, Krishna J Rocha-Singh, Michael R Jaff, Erwin Blessing, Beatrice Amann-Vesti, Marek Krzanowski, Patrick Peeters, Dierk Scheinert, Giovanni Torsello, Sebastian Sixt, Gunnar Tepe
BACKGROUND: Studies assessing drug-coated balloons (DCB) for the treatment of femoropopliteal artery disease are encouraging. However, challenging lesions, such as severely calcified, remain difficult to treat with DCB alone. Vessel preparation with directional atherectomy (DA) potentially improves outcomes of DCB. METHODS AND RESULTS: DEFINITIVE AR study (Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency-A Pilot Study of Anti-Restenosis Treatment) was a multicenter randomized trial designed to estimate the effect of DA before DCB to facilitate the development of future end point-driven randomized studies...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895369/the-role-of-intravascular-ultrasound-in-lower-limb-revascularization-in-patients-with-peripheral-arterial-disease
#4
Gregory C Makris, Pavlina Chrysafi, Mark Little, Rafiuddin Patel, Mark Bratby, Andrew Wigham, Susan Anthony, Raman Uberoi
INTRODUCTION: The aim of this review is to explore the safety and effectiveness of intravascular ultrasound (IVUS) during lower limb endovascular interventions in patients with peripheral arterial disease (PAD). METHODS: A systematic review of the PubMed and Scopus databases was performed according to PRISMA guidelines. Clinical studies evaluating IVUS as an adjunct to angiography during revascularization procedures in patients with PAD were included. RESULTS: Thirteen studies were identified, with a total number of 2,258 patients having had IVUS for PAD intervention...
September 11, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28890526/five-year-clinical-outcomes-after-drug-eluting-stent-implantation-following-rotational-atherectomy-for-heavily-calcified-lesions
#5
Hiroyuki Jinnouchi, Shoichi Kuramitsu, Tomohiro Shinozaki, Takashi Hiromasa, Yohei Kobayashi, Yasuaki Takeji, Mizuki Miura, Hisaki Masuda, Yukiko Matsumura, Yuhei Yamaji, Kenichi Sakakura, Takenori Domei, Yoshimitsu Soga, Makoto Hyodo, Shinichi Shirai, Kenji Ando
BACKGROUND: Percutaneous coronary intervention for heavily calcified lesions requires rotational atherectomy (RA). Long-term clinical outcomes after drug-eluting stent (DES) implantation following (RA) for heavily calcified lesions remain unclear. We assessed 5-year clinical outcomes after DES implantation following RA.Methods and Results:Between March 2006 and September 2011, 219 consecutive patients with 219 lesions treated with DES following RA, were retrospectively enrolled. The cumulative 5-year incidence of target-lesion revascularization (TLR) and definite stent thrombosis (ST) were assessed...
September 9, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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
#6
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
#7
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
#8
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...
September 1, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28860893/calcification-remodeling-index-characterized-by-cardiac-ct-as-a-novel-parameter-to-predict-the-use-of-rotational-atherectomy-for-coronary-intervention-of-lesions-with-moderate-to-severe-calcification
#9
Mengmeng Yu, Yuehua Li, Wenbin Li, Zhigang Lu, Meng Wei, Jiayin Zhang
OBJECTIVE: To assess the feasibility of calcification characterization by coronary computed tomography angiography (CCTA) to predict the use of rotational atherectomy (RA) for coronary intervention of lesions with moderate to severe calcification. MATERIALS AND METHODS: Patients with calcified lesions treated by percutaneous coronary intervention (PCI) who underwent both CCTA and invasive coronary angiography were retrospectively included in this study. Calcification remodeling index was calculated as the ratio of the smallest vessel cross-sectional area of the lesion to the proximal reference luminal area...
September 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/28844031/state-of-the-art-evolving-concepts-in-the-treatment-of-heavily-calcified-and-undilatable-coronary-stenoses-from-debulking-to-plaque-modification-a-40-year-long-journey
#10
Emanuele Barbato, Evan Shlofmitz, Anastasios Milkas, Richard Shlofmitz, Lorenzo Azzalini, Antonio Colombo
Since the first balloon angioplasty by Andreas Grüntzig 40 years ago, interventional cardiology has witnessed the introduction of countless tools and techniques that have significantly contributed to broadening the application of percutaneous coronary interventions (PCI) in unprecedented anatomic settings. Heavily calcified, fibrotic coronary stenosis has traditionally represented a very challenging scenario for PCI, and a very common indication for surgical revascularisation. This was mostly due to the difficulty in adequately dilating these lesions and/or to the inability to deliver and implant stents appropriately, which is often associated with high rates of procedural complications and suboptimal long-term clinical outcomes...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28842147/comparison-of-in-hospital-outcomes-after-percutaneous-revascularization-for-peripheral-arterial-disease-in-patients-with-a-body-mass-index-of-30%C3%A2-kg-m-2-versus-%C3%A2-30%C3%A2-kg-m-2-from-the-national-inpatient-sample
#11
Rajkumar Doshi, Gaurav Rao, Evan Shlofmitz, Joseph Donnelly, Perwaiz Meraj
Obesity is an independent risk factor for cardiovascular disease and mortality which may affect the outcomes of patients with peripheral arterial disease (PAD). However, the exact role of obesity in patients with PAD who underwent percutaneous revascularization is not well defined. We sought to analyze in-hospital outcomes and characteristics in obese patients who underwent percutaneous treatment for PAD. We identified study cohorts who underwent percutaneous treatment for PAD from 2012 to 2014 using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic and procedures codes specific for PAD and endovascular treatment...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28841129/stem-cell-smart-technology-where-are-we-now-and-how-far-we-have-to-go
#12
Sherif Sultan, Edel P Kavanagh, Robert Michalus, Niamh Hynes
Approximately eight million people in the United States have peripheral arterial disease, which increases exponentially with age. There have been a plethora of available treatments including surgery, angioplasty, atherectomy, laser technology, and cell-based therapies. Cell-based therapies were developed in the hope of translating laboratory-based technology into clinical successes. However, clinical results have been disappointing. Infusion or injection for stem cell therapy is still considered experimental and investigational, and major questions on safety and durability have arisen...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28818353/does-calcium-burden-impact-culprit-lesion-morphology-and-clinical-results-an-adapt-des-ivus-substudy
#13
Peiren Shan, Gary S Mintz, Bernhard Witzenbichler, D Christopher Metzger, Michael J Rinaldi, Peter L Duffy, Giora Weisz, Thomas D Stuckey, Bruce R Brodie, Philippe Généreux, Aaron Crowley, Ajay J Kirtane, Gregg W Stone, Akiko Maehara
BACKGROUND: Increasing coronary lesion calcification is thought to be associated with adverse percutaneous coronary intervention (PCI) and clinical outcomes. We investigated the effects of calcium burden on culprit lesion morphology and clinical events after intravascular ultrasound (IVUS)-guided PCI in the ADAPT-DES study. METHODS: ADAPT-DES was a prospective, multicenter registry of 8582 consecutive patients undergoing successful PCI using DES. A pre-specified virtual histology (VH)-IVUS substudy of 638 culprit lesions (638 patients) had both pre- and post-PCI VH-IVUS...
August 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28815727/gender-disparities-among-patients-with-peripheral-arterial-disease-treated-via-endovascular-approach-a-propensity-score-matched-analysis
#14
Rajkumar Doshi, Priyank Shah, Perwaiz Meraj
BACKGROUND: Remarkable improvement in the treatment of Peripheral Arterial Disease (PAD) has led to changes in revascularization strategies from traditional open surgery to less invasive endovascular management. However, few studies are available on gender disparities in patients with PAD treated via an endovascular approach. This study was designed to analyze gender related differences with respect to in-hospital outcomes in PAD patients. METHODS: Our data was obtained from National Inpatient Sample (NIS) 2012 through 2014...
August 16, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28803800/-ping-pong-technique-for-treating-a-balloon-uncrossable-chronic-total-occlusion
#15
Michael Koutouzis, Grigorios Avdikos, Georgios Nikitas, Theodoros Zografos, Ioannis Tsiafoutis, Maria Agelaki, Efstathios Lazaris
Balloon uncrossable lesions are a well-known challenge during chronic total occlusion (CTO) interventions. The technique of using two different catheters into the same coronary artery, the so-called "ping-pong" technique, is a technique described for treating complications during percutaneous coronary intervention (PCI), like perforations or rotational atherectomy burr entrapment. We describe a case where the "ping-pong" technique was successfully used to facilitate treatment of a balloon uncrossable CTO lesion...
July 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28781024/intraluminal-intensity-of-blood-speckle-on-intravascular-ultrasound-a-novel-predictor-of-periprocedural-myocardial-injury-after-coronary-stenting
#16
Yoshiyuki Okuya, Yuichi Saito, Hideki Kitahara, Takashi Nakayama, Yoshihide Fujimoto, Yoshio Kobayashi
The difference in the intraluminal intensity of blood speckle (IBS) on integrated backscatter-intravascular ultrasound (IB-IVUS) across a coronary artery stenosis (i.e., ΔIBS) has previously shown a negative correlation with fractional flow reserve, reflecting an impaired coronary blood flow. Periprocedural myocardial injury (PMI) after coronary stenting has also been associated with coronary circulatory dysfunction. The aim of this study was to investigate the relation between ΔIBS after coronary stenting and PMI...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28766833/coronary-atherectomy-is-associated-with-improved-procedural-and-clinical-outcomes-among-patients-with-calcified-coronary-lesions-insights-from-the-va-cart-program
#17
Ehrin J Armstrong, Maggie A Stanislawski, Damianos G Kokkinidis, Mary E Plomondon, Anna E Barón, Jay Giri, Kendrick A Shunk, Subhash Banerjee, Thomas M Maddox, Stephen W Waldo
OBJECTIVES: We sought to evaluate the prevalence of calcified coronary lesions and the association between the use of atherectomy and clinical outcomes. BACKGROUND: Calcified coronary arteries are associated with an increased risk of procedural complications during percutaneous coronary intervention (PCI). The outcomes of coronary atherectomy for adjunctive treatment of calcified coronary lesions are not well described. METHODS: We identified all patients treated for calcified coronary lesions at VA hospitals...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28759543/endovascular-repair-of-peripheral-arterial-disease-midterm-results-from-a-single-center
#18
Kemal Korkmaz, Hikmet Selcuk Gedik, Ali Baran Budak, Serdar Gunaydin, Kerim Cagli
OBJECTIVE: One thousand consecutive patients who underwent endovascular repair in an 8-year period were studied retrospectively to evaluate technical success, freedom from reinterventions, early clinical outcome, and risk factors for restenosis/occlusion. METHODS: Mean ± SD Rutherford class was 3.29 ± 0.8. A total of 755 patients have claudication, 423 from rest pain, and 569 from ischemic ulceration. RESULTS: A total of 552 men and 448 women (mean ± SD = 69...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28756957/comparison-of-the-diameters-of-the-major-epicardial-coronary-arteries-by-angiogram-in-asian-indians-versus-european-americans-40-years-of-age-undergoing-percutaneous-coronary-artery-intervention
#19
COMPARATIVE STUDY
Amgad N Makaryus, Rajiv Jauhar, Leanne M Tortez, Renee Pekmezaris
Coronary artery disease (CAD) rates are higher in Asian-Indians than in Caucasians. CAD occurs at an earlier age in this group, with about a quarter of all myocardial infarctions occurring under the age of 40. Previous reports have suggested smaller coronary artery size in Asian-Indians as a major cause for increased CAD in this population. This study sought to evaluate the size of normal "atheroma-free" segments of the epicardial coronary arteries in Asian-Indians and Caucasians aged ≤40 years undergoing coronary artery intervention in other diseased segments...
September 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28756420/safety-and-feasibility-of-rotational-atherectomy-in-elderly-patients-with-severe-aortic-stenosis
#20
Matthew Lippmann, Jigar Patel, Jared Kvapil, David Westover, Michael Pierpoline, Peter Tadros, Mark Wiley, George Zorn, Greg Muehlebach, Ashwani Mehta, Eric Hockstad, Matthew Earnest, Kamal Gupta
BACKGROUND: Percutaneous coronary intervention (PCI) followed by transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis (AS) and coronary artery disease (CAD). In many, the coronary arteries are severely calcified and best treated with rotational atherectomy (RA). However, RA is not routinely performed in severe AS patients due to safety concerns. There is a paucity of data on the safety of RA in severe AS patients with calcific CAD...
August 2017: Journal of Invasive Cardiology
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