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Complex pci

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143 papers 0 to 25 followers
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
#1
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/28258729/comparison-of-rotational-atherectomy-versus-orbital-atherectomy-for-the-treatment-of-heavily-calcified-coronary-plaques
#2
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/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
#3
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/28303645/zero-contrast-percutaneous-coronary-intervention-on-calcified-lesions-facilitated-by-rotational-atherectomy
#4
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/28197870/intravascular-ultrasound-guidance-of-percutaneous-coronary-intervention-in-ostial-chronic-total-occlusions-a-description-of-the-technique-and-procedural-results
#5
Nicola Ryan, Nieves Gonzalo, Philip Dingli, Oscar Vedia Cruz, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ivan Nuñez-Gil, María Del Trigo, Pablo Salinas, Carlos Macaya, Antonio Fernandez-Ortiz, Javier Escaned
Inability to cross the lesion with a guidewire is the most common reason for failure in percutaneous revascularization (PCI) of chronic total occlusions (CTOs). An ostial or stumpless CTO is an acknowledged challenge for CTO recanalization due to difficulty in successful wiring. IVUS imaging provides the opportunity to visualize the occluded vessel and to aid guidewire advancement. We review the value of this technique in a single-centre experience of CTO PCI. This series involves 22 patients who underwent CTO-PCI using IVUS guidance for stumpless CTO wiring at our institution...
February 14, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28242587/impact-of-crossing-strategy-on-mid-term-outcomes-following-percutaneous-revascularisation-of-coronary-chronic-total-occlusions
#6
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
AIMS: To compare the impact of crossing strategies on mid-term outcomes following chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS AND RESULTS: We compiled a multicentre registry of consecutive patients undergoing successful CTO PCI. Patients were divided in three groups: true-to-true (TTT) approach, modern dissection/re-entry (DR) techniques (CrossBoss/Stingray, reverse CART), and old DR techniques (LAST, STAR, CART). Cox regression was used to identify independent predictors of major adverse cardiac events (MACE: cardiac death, myocardial infarction and target-vessel revascularisation)...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#7
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28316035/management-of-percutaneous-coronary-intervention-complications
#8
REVIEW
Gregory Means, Christopher End, Prashant Kaul
With the recent increase in complex coronary interventions including percutaneous coronary intervention (PCI) for chronic total occlusions and complex higher risk (and indicated) patients, the spectrum of potential periprocedural complications and their prompt management has become even more relevant. Vascular access-related problems remain the most prevalent of all PCI complications and with randomized controlled trial data from over 20,000 patients supporting the superiority of radial over femoral access in reducing bleeding and vascular complications, a default radial strategy should be promoted...
April 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28318134/long-term-clinical-outcomes-of-successful-revascularization-with-drug-eluting-stents-for-chronic-total-occlusions-a-systematic-review-and-meta-analysis
#9
Lei Gao, Yabin Wang, Yuqi Liu, Feng Cao, Yundai Chen
OBJECTIVES: To determine whether successful percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) have beneficial effects on long-term outcomes in patients with chronic total occlusions (CTOs) compared with failed PCIs for CTOs. BACKGROUND: Several observational studies have evaluated the long-term clinical outcomes of successful PCIs using DESs for CTOs. However, the results of these studies were inconsistent and inconclusive. METHODS: We searched five online electronic databases to identify all the publications assessing the long-term outcomes of successful and failed PCIs using DESs for CTOs...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28116778/percutaneous-coronary-intervention-of-complex-calcified-lesions-with-drug-coated-balloon-after-rotational-atherectomy
#10
Tuomas T Rissanen, Sanna Uskela, Antti Siljander, Jussi M Kärkkäinen, Pirjo Mäntylä, Juha Mustonen, Jaakko Eränen
OBJECTIVES: We investigated the safety and efficacy of PCI using drug-coated balloon (DCB) after rotational atherectomy (rotablation) in a retrospective single center study in patients with calcified de novo coronary lesions. The majority of patients had an increased risk for bleeding. BACKGROUND: DCB has been effective in the treatment of in-stent restenosis, small vessels, and bifurcations. DCB enables short one month dual antiplatelet treatment. No published data exist on the use of DCB after rotablation...
January 23, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28168062/undilatable-stent-neoatherosclerosis-treated-with-ad-hoc-rotational-atherectomy
#11
Michael Koutouzis, Maria Agelaki, Christos Maniotis, Ioannis Tsiafoutis, Vasileios Patris, Mihalis Argyriou
A middle age woman with known ischemic heart disease and old stents in proximal left anterior descending coronary artery (LAD) was admitted to Coronary Care Unit with acute coronary syndrome. The coronary angiography showed one vessel disease with significant restenosis within the previously implanted stents. The lesion was tough and remained undilatable despite high pressure balloon inflation. Eventually, the balloon ruptured creating a massive dissection of the LAD beginning immediately after the distal part of the undilatable lesion...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/27862848/safety-and-efficacy-of-rotational-atherectomy-for-the-treatment-of-undilatable-underexpanded-stents-implanted-in-calcific-lesions
#12
Luca A Ferri, Richard J Jabbour, Francesco Giannini, Susanna Benincasa, Marco Ancona, Damiano Regazzoli, Antonio Mangieri, Matteo Montorfano, Antonio Colombo, Azeem Latib
OBJECTIVES: Coronary stent underexpansion is a known risk factor for in-stent restenosis and stent thrombosis. There are limited options once noncompliant balloons have failed to achieve optimal stent expansion. Excimer Laser Coronary Angioplasty with contrast medium injection is one possibility, but not readily available. Rotational atherectomy is an alternative, and has been described in case reports, but concerns exist regarding safety. METHODS: All consecutive patients undergoing rotational atherectomy for symptomatic in-stent restenosis due to stent underexpansion resistant to noncompliant balloon postdilatation between January 2005 and December 2015 were analysed...
November 10, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27894264/optical-coherence-tomography-findings-after-longitudinal-ablation-for-an-underexpanded-stent-in-a-heavily-calcified-lesion-a-case-report
#13
Masahiro Koide, Keiji Inoue, Akiko Matsuo, Hiroshi Fujita
BACKGROUND: Heavy coronary artery calcification is responsible for stent underexpansion, which is associated with increased in-stent restenosis. Here we report a case in which optical coherence tomography (OCT) demonstrated that the metal component of an underexpanded stent previously implanted in a heavy calcified lesion had been completely removed after ablation with rotational atherectomy. CASE PRESENTATION: An 83-year-old man with exertional angina was referred to our hospital...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27974432/incidence-and-determinants-of-complications-in-rotational-atherectomy-insights-from-the-national-clinical-data-j-pci-registry
#14
Kenichi Sakakura, Taku Inohara, Shun Kohsaka, Tetsuya Amano, Shiro Uemura, Hideki Ishii, Kazushige Kadota, Masato Nakamura, Hiroshi Funayama, Hideo Fujita, Shin-Ichi Momomura
BACKGROUND: The usage of rotational atherectomy (RA) is growing in the current percutaneous coronary intervention (PCI) because of the expansion of PCI indication to more complex lesions. However, the complications after RA have been linked to procedure-related morbidity and mortality. The purpose of this study was to investigate the incidence and determinants of complications in RA using a large nationwide registration system in Japan (J-PCI). METHODS AND RESULTS: The primary composite outcome of this study was defined as the occurrence of in-hospital death, cardiac tamponade, and emergent surgery after RA...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27974433/rotational-atherectomy-in-clinical-practice-the-art-of-tightrope-walking
#15
EDITORIAL
Goran Stankovic, Dejan Milasinovic
No abstract text is available yet for this article.
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27990696/comparison-of-bailout-and-planned-rotational-atherectomy-for-heavily-calcified-coronary-lesions-a-single-center-experience
#16
Abdelhakim Allali, Mohamed Abdel-Wahab, Dmitriy S Sulimov, John Jose, Volker Geist, Guido Kassner, Gert Richardt, Ralph Toelg
OBJECTIVES: The aim of this study was to compare outcomes of bailout and planned rotational atherectomy (RA) in the treatment of calcified coronary lesions. BACKGROUND: Current guidelines recommend RA as a bailout procedure for calcified or fibrotic lesions that cannot be adequately dilated before stenting. Nonetheless, planned RA is sometimes performed in certain challenging anatomies. METHODS: Data of patients treated with RA between 2002 and 2014 at a single-center registry were retrospectively analyzed...
December 19, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27998833/rotational-atherectomy-you-will-never-regret-using-it-but-you-often-regret-not-having-used-it
#17
Teresa Strisciuglio, Emanuele Barbato
No abstract text is available yet for this article.
December 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27998836/in-hospital-and-midterm-clinical-outcomes-of-rotational-atherectomy-followed-by-stent-implantation-the-rotate-multicentre-registry
#18
Hiroyoshi Kawamoto, Azeem Latib, Neil Ruparelia, Alfonso Ielasi, Fabrizio D'Ascenzo, Mauro Pennacchi, Gennaro Sardella, Roberto Garbo, Emanuele Meliga, Claudio Moretti, Marco Luciano Rossi, Patrizia Presbitero, Caroline J Magri, Sunao Nakamura, Antonio Colombo, Giacomo G Boccuzzi
AIMS: The aim of this multicentre study was to investigate the in-hospital and midterm outcomes of rotational atherectomy (RA) followed by metallic stent implantation. METHODS AND RESULTS: Between 2002 and 2013, 1,176 de novo lesions with calcified coronary lesions treated by RA and metallic stent implantation at nine institutions were assessed. Patients with ST-segment elevation myocardial infarction (STEMI) within 30 days, cardiogenic shock before the procedure, lesions with thrombus, and in-stent restenosis were excluded from the current analysis...
December 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/28029214/long-term-outcomes-of-rotational-atherectomy-for-the-percutaneous-treatment-of-chronic-total-occlusions
#19
Lorenzo Azzalini, Rustem Dautov, Soledad Ojeda, Antonio Serra, Susanna Benincasa, Barbara Bellini, Francesco Giannini, Jorge Chavarría, Livia L Gheorghe, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
OBJECTIVES: To study the long-term outcomes of rotational atherectomy (RA) for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). BACKGROUND: There is little evidence on the incidence, procedural results and long-term outcomes of RA for CTO PCI. METHODS: This registry included data from consecutive patients undergoing CTO PCI at four specialized centers. Major adverse cardiac events (MACE: cardiac death, target-vessel myocardial infarction and ischemia-driven target-vessel revascularization) on follow-up were the primary endpoint...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27998837/rotational-atherectomy-in-acute-coronary-syndrome-early-and-midterm-outcomes-from-a-multicentre-registry
#20
Mario Iannaccone, Fabio Piazza, Giacomo G Boccuzzi, Fabrizio D'Ascenzo, Azeem Latib, Mauro Pennacchi, Marco Luciano Rossi, Fabrizio Ugo, Emanuele Meliga, Hiroyoshi Kawamoto, Claudio Moretti, Alfonso Ielasi, Roberto Garbo, Antonio H Frangieh, David Hildick-Smith, Christian Templin, Antonio Colombo, Gennaro Sardella
AIMS: The safety and efficacy of rotational atherectomy (RA) in patients presenting with non-ST-elevation myocardial infarction (NSTE-ACS) remain to be defined. The aim of our study was to assess the safety and efficacy of RA in NSTE-ACS patients with reference to both short- and long-term follow-up. METHODS AND RESULTS: This was an observational retrospective registry which enrolled all consecutive patients undergoing RA, comparing patients with stable angina (SA) and NSTE-ACS...
December 20, 2016: EuroIntervention
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