Laser Atheroablation in Challenging Coronary Lesions

2015 ◽  
pp. 97-102
Author(s):  
Itsik Ben-Dor ◽  
Ron Waksman
Keyword(s):  
Coronary Lesions

Patient Selection and Procedural Considerations for Coronary Orbital Atherectomy System

2016 ◽  
Vol 11 (1) ◽  
pp. 33
Author(s):  
Yohei Sotomi ◽  
◽  
◽  
◽  
◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Rotational Atherectomy ◽  
Percutaneous Coronary ◽  
Orbital Atherectomy ◽  
Long Term Follow Up ◽  
Coronary Lesions ◽  
Calcified Coronary Lesions

Despite advances in technology, percutaneous coronary intervention (PCI) of severely calcified coronary lesions remains challenging. Rotational atherectomy is one of the current therapeutic options to manage calcified lesions, but has a limited role in facilitating the dilation or stenting of lesions that cannot be crossed or expanded with other PCI techniques due to unfavourable clinical outcome in long-term follow-up. However the results of orbital atherectomy presented in the ORBIT I and ORBIT II trials were encouraging. In addition to these encouraging data, necessity for sufficient lesion preparation before implantation of bioresorbable scaffolds lead to resurgence in the use of atherectomy. This article summarises currently available publications on orbital atherectomy (Cardiovascular Systems Inc.) and compares them with rotational atherectomy.

Effect of enoxaparin on clinical events in complicated coronary lesions after percutaneous coronary intervention

2015 ◽  
Vol 36 (10) ◽  
pp. 1074
Author(s):  
Nian-zhong TANG ◽  
Shao-ping CHEN ◽  
Xiu-ying SHI ◽  
Yi-feng JIANG ◽  
Li SUN ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Clinical Events ◽  
Percutaneous Coronary ◽  
Coronary Lesions

Vasculoprotective Role of Inducible Nitric Oxide Synthase at Inflammatory Coronary Lesions Induced by Chronic Treatment With Interleukin-1β in Pigs in Vivo

Circulation ◽  
1997 ◽  
Vol 96 (9) ◽  
pp. 3104-3111 ◽  
Author(s):  
Yoshihiro Fukumoto ◽  
Hiroaki Shimokawa ◽  
Toshiyuki Kozai ◽  
Toshiaki Kadokami ◽  
Kouichi Kuwata ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Nitric Oxide Synthase ◽  
Inducible Nitric Oxide Synthase ◽  
Chronic Treatment ◽  
Interleukin 1Β ◽  
Coronary Lesions ◽  
Oxide Synthase ◽  
Inducible Nitric Oxide

Hyperemic hemodynamic characteristics of serial coronary lesions assessed by pullback pressure gradients

2021 ◽  
Author(s):  
Alessandro Candreva ◽  
Takuya Mizukami ◽  
Jeroen Sonck ◽  
Daniel Munhoz ◽  
Sakura Nagumo ◽  
...  
Keyword(s):  
Pressure Gradients ◽  
Hemodynamic Characteristics ◽  
Coronary Lesions

Functional assessment of myocardial ischemia by intracoronary electrocardiogram

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.R Bigler ◽  
F Praz ◽  
G.C.M Siontis ◽  
M Stoller ◽  
R Grossenbacher ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
Primary Study ◽  
Coronary Perfusion ◽  
Funding Source ◽  
Maximal Heart Rate ◽  
Fractional Flow ◽  
Coronary Syndrome ◽  
Flow Reserve ◽  
St Segment ◽  
Coronary Lesions

Abstract Background In patients with chronic coronary syndrome (CCS), percutaneous coronary intervention (PCI) targets hemodynamically significant stenoses, i.e., those thought to cause ischemia. The hemodynamic severity of a coronary stenosis increases with its tightness and with the myocardial mass of viable myocardium downstream of the stenosis. Besides the structural angiographic approach, assessment of functional relevance by pressure measurements (fractional flow reserve, FFR; instantaneous wave-free ratio, iFR) is recommended. However, visual angiographic assessment continues to dominate the treatment decisions for intermediate coronary lesions. Conversely, intracoronary ECG (icECG) potentially provides an inexpensive, sensitive and direct measure of myocardial ischemia. Purpose The goal of this study was to test the accuracy of intracoronary ECG during pharmacologic inotropic stress to determine coronary lesion severity in comparison to established physiologic indices (FFR/iFR) as well as with quantitatively determined percent diameter stenosis (%S) using biplane coronary angiography. Method This was a prospective, open-label study in patients with CCS. The primary study end point was the maximal change in icECG ST-segment shift during pharmacologic inotropic stress induced by dobutamine plus atropine obtained within 1 minute after the point of maximal heart rate (estimated by the formula 220 - age). IcECG was acquired by attaching an alligator clamp to the angioplasty guidewire positioned downstream of a stenosis. For the pressure-derived ratios, i.e. FFR and iFR, the coronary perfusion pressure downstream of a lesion as well as the aortic pressure were continuously recorded. Results One hundred patients were included in the study. Pearson-Correlation coefficient was significant between icECG and all three comparators (%S p<0.001, iFR p<0.001, FFR p<0.001). Using the FFR threshold of 0.80 defining coronary hemodynamic significance, ROC-analysis of the absolute icECG ST-segment shift showed an area under the curve (AUC) of 0.708±0.053 (p=0.0001, n=100, FFR<0.80 n=41). AUC for iFR was 0.919±0.030 (p<0.0001), for percent diameter stenosis it was 0.867±0.036 (p<0.0001). Conclusions During pharmacologic inotropic stress, intracoronary ECG ST-segment shift provides specific evidence for regional myocardial ischemia irrespective of the etiology and thus, provides an additional (patho-)physiologic information for decision making in borderline coronary lesions. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Swiss Heart Foundation

scholarly journals INTRAVASCULAR LITHOTRIPSY FOR THE TREATMENT OF SEVERELY CALCIFIED CORONARY LESIONS - A PATIENT LEVEL POOLED ANALYSIS OF THE DISRUPT CAD I, II, III AND IV STUDIES

2021 ◽  
Vol 77 (18) ◽  
pp. 894
Author(s):  
Robert Francis Riley ◽  
Dean Kereiakes ◽  
Carlo Di Mario ◽  
Jean Fajadet ◽  
Richard Shlofmitz ◽  
...  
Keyword(s):  
Pooled Analysis ◽  
Patient Level ◽  
Coronary Lesions ◽  
Calcified Coronary Lesions
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