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https://www.readbyqxmd.com/read/28646446/innovations-in-the-endovascular-management-of-critical-limb-ischemia-retrograde-tibiopedal-access-and-advanced-percutaneous-techniques
#1
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28631258/long-term-effects-of-rotational-atherectomy-in-patients-with-heavy-calcified-coronary-artery-lesions-a-single-centre-experience
#2
Stanisław Bartuś, Rafał Januszek, Jacek Legutko, Łukasz Rzeszutko, Artur Dziewierz, Dariusz Dudek
BACKGROUND: Rotational atherectomy (RA) plays a significant role in contemporary percutaneous coronary interventions (PCI), especially in the era of population aging and expansion of PCI indications. AIM: The aim of the current study was to evaluate the rate of periprocedural complications, the long-term effectiveness of RA, and potential factors influencing the incidence of major adverse cardiac events (MACE) and major cardiac as well as cerebrovascular events (MACCE) after RA...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28623669/outcomes-after-successful-percutaneous-coronary-intervention-of-calcified-lesions-using-rotational-atherectomy-cutting-balloon-angioplasty-or-balloon-only-angioplasty-before-drug-eluting-stent-implantation
#3
Björn Redfors, Akiko Maehara, Bernhard Witzenbichler, Giora Weisz, Thomas D Stuckey, Timothy D Henry, Thomas McAndrew, Roxana Mehran, Ajay J Kirtane, Gregg W Stone, Philippe Généreux
OBJECTIVES: To report adverse event rates after rotational atherectomy (RA) with contemporary drug-eluting stent (DES) implantation and compare RA to cutting balloon (CB) angioplasty and balloon-only angioplasty (BA) in the all-comers ADAPT-DES trial. BACKGROUND: Percutaneous coronary intervention (PCI) of calcified lesions is increasingly common and is associated with a high risk of adverse events. RA can ablate calcified plaque and facilitate stent delivery; however, in conjunction with first-generation DES, RA was not superior to BA alone in regard to adverse events...
June 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28612417/length-and-pressure-matter-expediting-evidence-based-progress-in-femoropoliteal-intervention
#4
EDITORIAL
Arka Chatterjee, William B Hillegass
Preprocedural lesion length and ankle-brachial indices (ABI) synergistically predict 12-month patency and repeat revacularization in claudicants treated with bare metal nitinol stents for femoropopliteal disease. This predictive length-ABI model will permit broader evidence-based indirect comparisons of newer femoropopliteal approaches such as drug eluting balloon treatment with or without atherectomy. The length-ABI model is a step to supplement and supplant randomized controlled trials with indirect comparisons as the necessary evidence source expediting innovation and optimizing personalized endovascular therapy for infrainguinal obstructive peripheral arterial disease...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28595481/retrograde-popliteal-access-to-percutaneous-peripheral-intervention-for-chronic-total-occlusion-of-superficial-femoral-arteries
#5
Mert Dumantepe
OBJECTIVE: The aim of this study is to present our initial experience with the use of the retrograde popliteal artery access in patients with chronic total occlusions of superficial femoral artery (SFA). METHOD: From July 2012 to May 2014, a total of 28 patients (20 men, mean age 61.2 ± 11.5 years) with total occlusion of the SFA and good distal runoff were treated with percutaneous atherectomy, balloon angioplasty, and stenting (mean length 165.3 ± 57.5 mm, range 72-336 mm)...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28570235/five-year-freedom-from-target-lesion-revascularization-using-excimer-laser-ablation-therapy-in-the-treatment-of-in-stent-restenosis-of-femoropopliteal-arteries
#6
Nicolas W Shammas, Gail A Shammas, Lorraine Arikat, Andrew N Shammas, Alec Darrow, Avantika Banerjee, Benjamin Rudy
BACKGROUND: Target-lesion revascularization (TLR) and loss of patency remain high following treatment of in-stent restenosis (ISR) of the femoropopliteal (FP) artery. Excimer laser atherectomy (ELA) is effective in reducing TLR and improves patency at 6-month and 1-year follow-up when compared with balloon angioplasty (PTA). The long-term sustainability of these early results is unknown. We present a retrospective analysis from our center on the 5-year outcomes of ELA in the treatment of ISR of the FP arteries...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28566941/embolic-protection-using-the-wirion-embolic-protection-system-with-jetstream-atherectomy-in-a-patient-with-superficial-femoral-artery-chronic-total-occlusion
#7
Nicolas W Shammas
Distal embolization is a common occurrence with peripheral arterial interventions and is more frequent with the use of atherectomy devices. We report the first case of JetStream atherectomy (Boston Scientific, Maple Grove, MN) with the use of the novel WIRION embolic protection system filter. The procedure was performed successfully with no distal embolizations beyond the filter and with no complications in the delivery or retrieval of the filter. The pros and cons of the off label use of this filter with JetStream atherectomy are discussed...
June 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28548625/acute-procedural-outcomes-of-orbital-atherectomy-for-the-treatment-of-common-femoral-artery-disease-sub-analysis-of-the-confirm-registries
#8
Michael S Lee, Daniel Heikali, Jihad Mustapha, George Adams, Ehtisham Mahmud
This analysis compared the angiographic outcomes of patients treated with orbital atherectomy for calcified common femoral artery (CFA) and superficial femoral artery (SFA) disease. The ideal revascularization strategy for CFA disease is unknown. Endarterectomy has been considered the standard of care for CFA disease for over 50 years. Endovascular intervention is becoming more commonly used to revascularize the CFA given the advances in technology and the less invasive nature of the procedure. Patient demographics, lesion characteristics, and procedure data for all CONFIRM patients with at least one CFA lesion location ( n=147 patients; n=200 lesions) were compared to patients with at least one SFA lesion location ( n=1508 patients; n=2367 lesions)...
May 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
July 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28450676/predictors-of-recurrent-in-stent-restenosis-after-paclitaxel-coated-balloon-angioplasty
#20
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
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