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https://www.readbyqxmd.com/read/28342839/a-case-of-severely-calcified-neoatherosclerosis-after-paclitaxel-eluting-stent-implantation
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28255104/-single-operator-technique-for-advancing-the-orbital-atherectomy-device
#11
Michael S Lee, Heajung Nguyen, Daniel Philipson, Richard A Shlofmitz
OBJECTIVE: We assessed the feasibility and safety of the "single-operator" technique in which the operator autonomously advanced the orbital atherectomy (OA) device while maintaining wire position. BACKGROUND: Severe coronary artery calcification (CAC) increases the complexity of percutaneous coronary intervention (PCI), and is associated with lower procedural success rates and higher rates of adverse outcomes, including death, myocardial infarction, target-vessel revascularization, and stent thrombosis...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28250353/when-a-burr-can-not-penetrate-the-calcified-lesion-increasing-burr-size-as-well-as-decreasing-burr-size-can-be-a-solution-in-rotational-atherectomy
#12
Kenichi Sakakura, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
In rotational atherectomy (RA), several burr sizes are available, such as 1.25 mm, 1.5 mm, 1.75 mm, or ≥ 2.0 mm. It is important to select an appropriate burr size for each lesion because rotational atherectomy has several unique complications regarding burrs such as entrapment or perforation. When a burr cannot penetrate the lesion, downsizing of the burr is generally recommended. Also, if the smallest burr (1.25 mm) cannot penetrate the lesion, a change to a more supportive or larger French guiding catheter has been recommended...
March 2, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28239949/temporal-trends-in-peripheral-arterial-interventions-observations-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2-pvi
#13
Michael P Thomas, Yeo Jung Park, Scott Grey, Theodore L Schreiber, Hitinder S Gurm, Dale Leffler, Thomas P Davis, Peter Henke, Paul Michael Grossman
OBJECTIVES: The aim is to examine trends in procedural indication, arterial beds treated, and device usage in peripheral arterial interventions (PVIs). BACKGROUND: There is little data on indication, vascular beds treated and devices utilized for peripheral arterial interventions. METHODS: We used data from 43 hospitals participating in the BMC2 VIC registry. PVIs were separated by year and divided by arterial segment. Lower extremity PVIs were subclassified as having been performed for claudication or critical limb ischemia (CLI)...
February 27, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28216476/combined-use-of-directional-atherectomy-and-drug-coated-balloon-for-the-endovascular-treatment-of-common-femoral-artery-disease-immediate-and-one-year-outcomes
#14
Angelo Cioppa, Eugenio Stabile, Luigi Salemme, Grigore Popusoi, Armando Pucciarelli, Fortunato Iacovelli, Antonella Arcari, Enrico Coscioni, Bruno Trimarco, Giovanni Esposito, Tullio Tesorio
AIMS: Surgical endarterectomy is the therapy of choice for atherosclerotic common femoral artery (CFA) obstruction. Recently, some large single-centre series have shown encouraging results for the percutaneous treatment of CFA obstructions. The purpose of this study was to evaluate the safety, feasibility, and one-year efficacy of the endovascular treatment of CFA obstructions with combined use of directional atherectomy (DA) and a paclitaxel-coated balloon (DCB). METHODS AND RESULTS: Between January 2012 and July 2014, 30 consecutive patients with severely calcified obstructions of the common femoral artery were treated in our centre using DA followed by DCB dilatation...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#15
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28191873/orbital-atherectomy-treatment-of-severely-calcified-coronary-lesions-in-patients-with-impaired-left-ventricular-ejection-fraction-one-year-outcomes-from-the-orbit-ii-study
#16
Michael S Lee, Brad J Martinsen, Richard Shlofmitz, Evan Shlofmitz, Arthur C Lee, Jeffrey Chambers
AIMS: Percutaneous coronary intervention (PCI) of severe coronary artery calcification (CAC) is challenging. The ORBIT II study demonstrated the safety and efficacy of orbital atherectomy (OA) in patients with severe CAC. Microparticulate liberated during OA may disturb coronary microcirculation. We evaluated OA treatment in patients with left ventricular systolic dysfunction. METHODS AND RESULTS: Patients were grouped by left ventricular ejection fraction (LVEF): 26-40% (n=33), 41-50% (n=90), and >50% (n=314)...
February 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28185445/a-comparative-study-of-percutaneous-atherectomy-for-femoropopliteal-arterial-occlusive-disease-experiences-in-160-patients
#17
Yongquan Gu, Mahmoud B Malas, Lixing Qi, Lianrui Guo, Jianming Guo, Hengxi Yu, Zhu Tong, Xixiang Gao, Jian Zhang, Zhonggao Wang
BACKGROUND: SiverHawk directional atherectomy has been used to treat more than 300 thousand cases of lower extremity atherosclerotic occlusive disease in the world since it was approved by FDA in 2003. This study to analyze the safety and effectiveness of symptomatic femoral popliteal atherosclerotic disease treated by directional atheroectomy (DA). METHODS: Clinical data of all consecutive patients treated with percutaneous atherectomy utilizing the SiverHawk plaque excision at one university hospital was retrospectively analyzed...
February 9, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28184335/drug-and-gene-eluting-stents-for-preventing-coronary-restenosis
#18
REVIEW
Kamali Manickavasagam Lekshmi, Hui-Lian Che, Chong-Su Cho, In-Kyu Park
Coronary artery disease (CAD) has been reported to be a major cause of death worldwide. Current treatment methods include atherectomy, coronary angioplasty (as a percutaneous coronary intervention), and coronary artery bypass. Among them, the insertion of stents into the coronary artery is one of the commonly used methods for CAD, although the formation of in-stent restenosis (ISR) is a major drawback, demanding improvement in stent technology. Stents can be improved using the delivery of DNA, siRNA, and miRNA rather than anti-inflammatory/anti-thrombotic drugs...
January 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/28181450/management-of-iatrogenic-aortal-dissection-as-a-complication-of-coronary-intervention-wait-and-watch
#19
Rajesh Dandale, Alexander Krapivsky, Feraydoon Niroomand
Iatrogenic aortic dissection (AD) is quite a rare complication during percutaneous coronary intervention (PCI). The exact mechanism of iatrogenic AD during PCI is unknown. A standard of care in the management of iatrogenic AD is still lacking. We describe a case of an 83-year-old man, with an aortocoronary bypass graft, who underwent complex PCI with rotational atherectomy catheterization with a radial approach for a chronic right coronary artery stenosis, complicated by AD. According to our experience, retrograde dissection into the aorta during PCI can be sealed with a coronary stent that covers the coronary ostium and should be treated conservatively in most circumstances, unless complication like extension of dissection into other vessels or pericardial effusion or hemodynamic instability occurs...
March 2017: Future Cardiology
https://www.readbyqxmd.com/read/28180008/use-of-orbital-atherectomy-in-acute-myocardial-infarction-via-the-transradial-approach
#20
REVIEW
Samer Mowakeaa, Branden Snyder, Nikolaos Kakouros
Severe coronary artery calcifications pose an ongoing challenge when performing percutaneous coronary interventions, resulting in an increased likelihood of procedural complications. Orbital atherectomy (OA) has emerged as a promising technology that helps improve outcomes in this complex patient population. Its safety and efficacy are yet to be demonstrated in the setting of acute myocardial infarction. We present a case of a patient with acute ST-elevation myocardial infarction (STEMI) evaluated with emergent transradial coronary angiography...
December 2016: Interventional Medicine & Applied Science
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