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Manish Mehta, Yi Zhou, Philip S K Paty, Medhi Teymouri, Kamran Jafree, Humayun Bakhtawar, Jeffrey Hnath, Paul Feustel
BACKGROUND: This study evaluated the feasibility, safety, and effectiveness of endovascular interventions for common femoral artery (CFA) occlusive disease. METHODS: Using a prospectively maintained multicenter database, we analyzed outcomes in 167 consecutive patients who underwent percutaneous CFA interventions for Rutherford class 3 to class 6 (R3-R6) disease. The standardized treatment approach included primary percutaneous transluminal angioplasty (PTA) only, atherectomy + PTA, and provisional stenting...
August 2016: Journal of Vascular Surgery
Ravi S Hira, Larry S Dean
Provisional use of rotational atherectomy (RA) is indicated for procedural success in heavily calcified lesions. In the current study, RA use at three high volume percutaneous coronary intervention (PCI) centers between 2005 and 2013 was 1.4%. MACE rate was 17.8% at median follow-up of 22 months. Peripheral vascular disease (PVD), diabetes mellitus (DM), acute coronary syndrome (ACS), and SYNTAX > 23 were found to be independently associated with MACE. With increasing complexity of disease and SYNTAX score, there is usually an increase in severity of calcification and need for atherectomy...
October 2016: Catheterization and Cardiovascular Interventions
Takayuki Warisawa, Toru Naganuma, Sunao Nakamura
We report a case of percutaneous coronary intervention in a bifurcation lesion involving left circumflex (LCx) artery and 2 major posterolateral (PL) arteries. The target LCx had diffuse long and severely calcified lesion with the acute takeoff angle from the left main. Despite adequate lesion preparation with rotational atherectomy and balloon angioplasty, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. Conventional use of guiding extension catheter (GEC) would have required removal of a wire from at least one PL because of the device interference in the GEC...
October 18, 2016: Cardiovascular Intervention and Therapeutics
Yohei Sotomi, Rafael Cavalcante, Richard A Shlofmitz, Pannipa Suwannasom, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zheng, Mohammad Abdelghani, Robbert J de Winter, Joanna J Wykrzykowska, Yoshinobu Onuma, Patrick W Serruys
AIMS: Recently, favourable procedural 30-day and one-year outcomes with the Diamondback 360 Orbital Atherectomy System (OAS) in the treatment of severely calcified lesions have been reported. The purpose of this study was to assess the therapeutic mechanism and efficacy of the OAS with optical coherence tomography (OCT) imaging. METHODS AND RESULTS: This was an observational imaging study in 18 patients with complex calcified coro-nary artery lesions who underwent percutaneous coronary intervention with the OAS...
October 20, 2016: EuroIntervention
Ron Waksman, Hector M Garcia-Garcia
No abstract text is available yet for this article.
October 20, 2016: EuroIntervention
C Mallikarjun Rao
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Takayuki Mori, Kenichi Sakakura, Hiroshi Wada, Yousuke Taniguchi, Kei Yamamoto, Yusuke Adachi, Hiroshi Funayama, Shin-Ichi Momomura, Hideo Fujita
While rotational atherectomy (RA) is used for complex lesions in percutaneous coronary intervention, there are several contraindications such as unprotected left main stenosis or left ventricular dysfunction. We previously reported that the incidence of in-hospital complications was significantly greater in off-label as compared to on-label use RA. However, the mid-term clinical outcomes between off-label and on-label RA have not been investigated. The purpose of this study was to compare the mid-term clinical outcomes between off-label (n = 156) and on-label RA (n = 94)...
October 5, 2016: Heart and Vessels
Umihiko Kaneko, Yoshifumi Kashima, Daitaro Kanno, Takuro Sugie, Ken Kobayashi, Tsutomu Fujita
Although performing rotational atherectomy (RA) requires guidewire exchange for the dedicated guidewire, RotaWire guidewire (Boston Scientific) exhibits much lower performance than conventional guidewire. Consequently, there are times when RotaWire cannot be advanced past the lesion independently or using a microcatheter exchange technique, rendering RA impossible. We present a case of a heavily calcified, device-uncrossable, and non-expansible chronic total occlusion lesion successfully revascularized with RA over RG3 guidewire (Asahi Intecc), which has a length of 330 cm, hydrophilic coating, and a 0...
September 28, 2016: Cardiovascular Intervention and Therapeutics
Judit Karacsonyi, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, John Bahadorani, Anthony Doing, Ziad A Ali, Aris Karatasakis, Barbara A Danek, Bavana V Rangan, Aya J Alame, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Balloon uncrossable lesions can be challenging to treat, requiring specialized techniques and equipment. METHODS: We examined the prevalence, clinical and angiographic characteristics, management and procedural outcomes of balloon uncrossable lesions in a multicenter chronic total occlusion (CTO) percutaneous coronary intervention (PCI) registry. RESULTS: Between 2012 and 2016, 718 CTO PCIs (in which the occlusion was successfully crossed with a guidewire) were performed in 701 patients at 11 US centers...
September 21, 2016: Catheterization and Cardiovascular Interventions
Monika Herten, Giovanni B Torsello, Eva Schönefeld, Stefan Stahlhoff
Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis...
2016: Vascular Health and Risk Management
C Caradu, A S Battut, C Gonthier, D Midy, E Ducasse
One third of patients with critical limb ischemia (CLI) has below the knee lesions and requires a restoration of direct blood flow into the foot. However, many of these patients are ineligible for open surgery. The primary goals thus become pain relief and limb salvage over patency. The angiosome concept helps determine the target artery to treat in priority. The endovascular approach has decreased morbidity and mortality rates compared to distal bypass surgery; while subintimal retrograde, trans-collateral and loop techniques push the limits of open surgery by reopening the plantar arch, thereby improving run-off...
September 1, 2016: Journal des Maladies Vasculaires
Tiberio M Frisoli, Harold Friedman, William W O'Neill
A patient was referred to us for Canadian Cardiovascular Society class III refractory angina. He was found to have in-stent restenosis within three layers of underexpanded stents implanted in 2004, 2011, and 2014. Rotational atherectomy safely yielded stent strut ablation (reduced to one layer), lesion expansion, and very good angiographic and physiologic results.
September 2016: Journal of Invasive Cardiology
Nicolas W Shammas, Gail A Shammas, Thomas Harris, Cara M Voelliger, Andrew N Shammas, Michael Jerin
Bailout stenting of the common femoral artery (CFA) may become necessary with failed balloon angioplasty or atherectomy or in case of bleeding requiring a covered stent over the arteriotomy site. Reaccessing the CFA through a previously placed stent may occur during angiography. The safety and effectiveness of applying a closure device, or manual compression to achieve hemostasis through an accessed stented CFA are unknown. All patients in our practice that underwent CFA stenting were identified using billing records for 3 years (January 1, 2010-February 28, 2013)...
September 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Adel Aminian, Juan F Iglesias, Carlos Van Mieghem, Andrea Zuffi, Angela Ferrara, Roukos Manih, Dariouch Dolatabadi, Jacques Lalmand, Shigeru Saito
PURPOSE: To assess the feasibility and safety of the 7 French (Fr) Glidesheath Slender for complex transradial (TR) percutaneous coronary interventions (PCI). BACKGROUND: The TR approach is increasingly used worldwide for coronary and peripheral vascular interventions. However, the small size of the radial artery remains an important limitation for the use of large-bore guiding catheters (>6 Fr), restricting thereby the treatment of highly complex lesions through the TR approach...
August 27, 2016: Catheterization and Cardiovascular Interventions
Michael S Lee, Arthur C Lee, Richard A Shlofmitz, Brad J Martinsen, Nick J Hargus, Mahir D Elder, Philippe Généreux, Jeffrey W Chambers
OBJECTIVES: To investigate the safety and efficacy of the coronary Orbital Atherectomy System (OAS) to prepare severely calcified lesions for stent deployment in patients grouped by renal function. BACKGROUND: Percutaneous coronary intervention (PCI) of severely calcified lesions is associated with increased rates of major adverse cardiac events (MACE), including death, myocardial infarction (MI), and target vessel revascularization (TVR) compared with PCI of non-calcified vessels...
August 27, 2016: Catheterization and Cardiovascular Interventions
Aly Tohamy, Margo Klomp, Hein Putter, Amr Youssef, Hamdy Shams-Eddin, Mahmoud Abdelsabour, M J Schalij, J Wouter Jukema
We assessed the very long-term follow-up of a large cohort of unselected patients treated with coronary rotational atherectomy (RA). All 143 patients who underwent RA at our institution from 2000 to 2013 and with complete baseline and follow-up information were analyzed in a retrospective manner. Major adverse cardiac events (MACE) were defined as the composite of target vessel revascularization (TVR), acute myocardial infarction, and all-cause mortality. The mean follow-up was 8.2 years. The 10-year cumulative incidence of MACE for all patients was 57...
August 23, 2016: Angiology
Xiaoyu Yang, Hector Tamez, Carol Lai, Kalon Ho, Donald Cutlip
OBJECTIVES: To assess the incidence of and outcomes related to periprocedural (Type 4a) myocardial infarction (MI) in a cohort of patients undergoing percutaneous coronary intervention (PCI) for stable coronary disease or non ST-elevation acute coronary syndrome with stable or falling cardiac troponin levels. BACKGROUND: The 2012 Third Universal Definition for Type 4a MI has not been prospectively studied in routine clinical practice. METHODS: The study included 516 patients undergoing eligible PCI at a single institution...
August 18, 2016: Catheterization and Cardiovascular Interventions
Yoshisato Shibata
No abstract text is available yet for this article.
June 20, 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
István F Édes, Zoltán Ruzsa, György Szabó, Árpád Lux, László Gellér, Levente Molnár, Fanni Nowotta, Ágota Hajas, Bálint Szilveszter, Dávid Becker, Béla Merkely
AIMS: Our aim was to examine procedural viability and midterm outcomes following the use of rotational atherectomy (RA) on malapposed, crippled, otherwise non-salvageable metallic stents (i.e., stentablation [SA]), and convey important procedural pointers for practitioners encountering such situations. METHODS AND RESULTS: Data on twelve SA subjects were analysed. The primary endpoint was procedural success: effective ablation of the malapposed stent and successful implantation of a new device...
2016: EuroIntervention
Michael S Lee, Evan Shlofmitz, Heajung Nguyen, Richard A Shlofmitz
OBJECTIVES: We evaluated the angiographic and clinical outcomes of orbital atherectomy to treat severely calcified coronary lesions in diabetic and non-diabetic patients. BACKGROUND: Diabetics have increased risk for death, myocardial infarction, and target vessel revascularization after percutaneous coronary intervention. Severely calcified coronary lesions are associated with increased cardiac events. Orbital atherectomy facilitates stent delivery and optimizes stent expansion by modifying severely calcified plaque...
October 2016: Journal of Interventional Cardiology
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