Search results for "Atherectomy"
showing 10 items of 13 documents
Percutaneous transluminal coronary rotary ablation with Rotablator (European experience)
1992
This study reports the results from 3 European centers using rotary ablation with Rotablator, a device that is inserted into the coronary artery and removes atheroma by grinding it into millions of tiny fragments. Rotary ablation was performed in 129 patients. Primary success (reduction in percent luminal narrowing greater than 20%, residual stenosis less than 50%, without complications) was achieved by rotary angioplasty alone in 73 patients (57%). An additional 38 patients (29%) had successful adjunctive balloon angioplasty. Thus primary success was achieved in 111 patients (86%) at the end of the procedure. Acute occlusion occurred in 10 patients (7.7%). Recanalization was achieved by ba…
High-frequency rotational ablation following failed percutaneous transluminal coronary angioplasty.
1994
Percutaneous transluminal coronary angioplasty (PTCA) failed in 29 of 1,150 patients (2.5%) after successful passage of the guide wire. The reasons for failure were inability to pass the lesion with a balloon in 28 patients and inability to dilate the lesion in 1 patient. In these patients (15 stenoses and 14 chronic occlusions) rotational ablation was performed. We were able to pass the burr through the lesion in all of them, resulting in a reduction of diameter stenosis from 87 +/- 15 to 51 +/- 18%. Rotational ablation alone was initially successful (stenoses reduction > 20% and residual stenoses < 50%) in 15 of 29 (52%) patients. Additional PTCA was performed in 21 of 29 (72%) patients, …
Successful use of impella CP through femoral access in a patient with bilateral iliac and aortic endoprosthesis in the setting of cardiogenic shock
2019
We report the case of a 67-year-old male, with previous history of severe peripheral vascular disease (abdominal aorta aneurism and bilateral iliac stenosis) requiring the implantation of 3 endoprostheses 7 months ago (Figure 1(A)), and previous myocardial infarction 10 years ago. The left ventricular ejection fraction (LVEF) was preserved at last control (58%). The patient was referred for acute coronary syndrome complicated with pulmonary oedema and cardiogenic shock. Echocardiography showed a severe impairment of LVEF (18%) and the patient was transferred to cathlab for emergency percutaneous coronary intervention (PCI). Coronary angiography via right femoral 7Fr access showed a chronic …
Excimer laser atherectomy in an uncrossable long chronic total occlusion through the subintimal space
2020
We present a successfully chronic total occlusions (CTO) coronary recanalisation with the subadventitial space by excimer laser atherectomy (ELCA) adjunctive therapy. Angiogram revealed non-significant diffuse disease of the left coronary system with a complex long proximal right coronary artery (RCA) CTO (J-CTO score 4) and collaterals (Rentrop Grade 2 and Werner classification CC1) from the septal branches (Figure 1, Panel A). CTO PCI of the RCA was then indicated and planned. Initially, antegrade approach and a retrograde approach technique were attempted without success. Thereafter, a rescue Antegrade Dissection Reentry strategy (ADR) was applied. A Pilot 200 (Abbott) was advanced in a …
Excimer laser technology in percutaneous coronary interventions: Cardiovascular laser society's position paper
2022
Excimer Laser Coronary Atherectomy (ELCA) is a well-established therapy that emerged for the treatment of peripheral vascular atherosclerosis in the late 1980s, at a time when catheters and materials were rudimentary and associated with the most serious complications. Refinements in catheter technology and the introduction of improved laser techniques have led to their effective use for the treatment of a wide spectrum of complex coronary lesions, such as thrombotic lesions, severe calcific lesions, non-crossable or non-expandable lesions, chronic occlusions, and stent under-expansion. The gradual introduction of high-energy strategies combined with the contrast infusion technique has enabl…
High-Frequency Rotational Angioplasty
1991
In 19 patients with significant coronary artery disease, PTCR was used instead of PTCA. The PTCR was successful in all patients, but in nine patients additional PTCA was successfully performed. Coronary luminal narrowing could be reduced from 78 ± 19% to 32 ± 14% after rotablation and by combined treatment to 21 ± 14%. Only in one patient did coronary dissection occur; the patient was sent to surgery and had an uneventful outcome. No vessel perforation was observed. In one patient peripheral diagonal branch occlusion occurred. All vessels were open according to 24-control coronary angiography. Restenosis (>70% stenosis) occurred in 4/15 patients controlled after 6 months, mainly in those wi…
High-Frequency rotablation of occluded coronary artery during heart catheterization
1989
High-frequency rotation atherectomy of an occluded left circumflex coronary artery was performed in a 45-year-old man. Over a 0.009 inch flexible tip steel wire a diamond-coated brass burr fasten to a flexible drive shaft that rotates and tracks was advanced. The drive shaft was connected to a turbine and driven by compressed air with 150,000 rpm. After rotablation of the posterior lateral branch over 3 cm with a 1.5 mm burr and rotablation with a 1.75 mm burr of the posterior branch of the left circumflex coronary artery the vessel was reopened with a smooth surface without perforation and dissection. 24 h control and 6 mo control revealed an open coronary vessel. High frequency rotating c…
High-speed rotational angioplasty-induced echo contrast in vivo and in vitro optical analysis
1992
High-speed rotational angioplasty is being evaluated as an alternative interventional device for the endovascular treatment of chronic coronary occlusions. It has been postulated that this type of angioplasty device may produce particulate debris or cavitations that induce myocardial ischemia. To determine the clinical presence of myocardial ischemia during rotational angioplasty, echocardiographic monitoring for wall motion abnormalities was performed in 9 patients undergoing rotational atheroablation using the Auth Rotablator for 10-sec intervals at 150,000 and 170,000 rpm. No wall motion abnormalities were detected in 5 patients evaluated with transesophageal echocardiography or in 4 pat…
Long-term outcome after drug-eluting stents implantation: Target lesion versus nontarget lesion repeated intervention
2010
Abstract We sought to investigate the relative clinical significance of target and nontarget lesions repeated percutaneous coronary intervention (re-PCI) in patients implanted with drug-eluting stents (DES). Out of 2626 consecutive DES patients, we retrospectively selected 166 (6.3%; 123 males, aged 65±10years) who had a clinically-driven re-PCI over a mean follow-up of 15months. Seventy-five patients (45%) underwent the second procedure for disease progression in nontarget lesions (nontarget lesion re-PCI group) while 91 (55%) showed target lesion in-stent restenosis or thrombosis (target lesion re-PCI group), with no significant intergroup difference in the temporal trends of re-PCI. The …
Use of the directional atherectomy for the treatment of femoro-popliteal lesions in patients with critical lower limb ischemia
2016
Femoro-popliteal PTA for the treatment of critical limb ischemia is frequently associated with unsatisfactory procedural success rates while directional atherectomy (DCA) has improved success rate since claudicant patients undergoing percutaneous treatment of femoro-popliteal obstructive disease. The aim of this prospective study is to evaluate the safety, efficacy and procedural success of DCA, at one year, in the percutaneous treatment of femoro-popliteal obstructive disease in patients with critical limb ischemia.Methods. From March 2012 to March 2013 18 consecutive patients with critical limb ischemia were treated with DCA (Turbohawk/ Covidien-ev3 Endovascular Inc., North Plymouth, Minn…