scholarly journals Contemporary Approach to Heavily Calcified Coronary Lesions

2019 ◽  
Vol 14 (3) ◽  
pp. 154-163 ◽  
Author(s):  
Carlotta Sorini Dini ◽  
Giulia Nardi ◽  
Francesca Ristalli ◽  
Alessio Mattesini ◽  
Brunilda Hamiti ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Multimodal Imaging ◽  
Interventional Cardiology ◽  
Percutaneous Treatment ◽  
Poor Clinical Outcome ◽  
Late Failure ◽  
Coronary Lesions ◽  
Technical Features ◽  
Calcified Coronary Lesions ◽  
Contemporary Approach

Percutaneous treatment of heavily calcified coronary lesions still represents a challenge for interventional cardiology, with higher risk of immediate complications, late failure due to stent underexpansion and malapposition, and consequently poor clinical outcome. Good characterisation of calcium distribution with multimodal imaging is important to improve the successful treatment of these lesions. The use of traditional or new dedicated devices for the treatment of calcified lesions allows better lesion preparation; therefore, it is important that we know the different mechanisms and technical features of these devices.

scholarly journals Intracoronary Lithoplasty in Percutaneous Treatment of Challenging Calcified Coronary Lesions

2020 ◽  
Vol 2 (11) ◽  
pp. 1679-1683
Author(s):  
Alfredo Marchese ◽  
Antonio Tito ◽  
Fabrizio Resta ◽  
Antonio Colombo
Keyword(s):  
Percutaneous Treatment ◽  
Coronary Lesions ◽  
Calcified Coronary Lesions

scholarly journals Bail-out unexpanded stent implantation in acute left main dissection treated with intra coronary lithotripsy: a case report

2019 ◽  
Vol 3 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Gabriele Tumminello ◽  
Chiara Cavallino ◽  
Andrea Demarchi ◽  
Francesco Rametta
Keyword(s):  
Case Report ◽  
Stent Implantation ◽  
Coronary Intervention ◽  
Percutaneous Treatment ◽  
High Rate ◽  
Percutaneous Technique ◽  
Left Main ◽  
Coronary Lesions ◽  
Bail Out ◽  
Calcified Coronary Lesions

Abstract Background The percutaneous treatment of heavily calcified coronary lesions is challenging and presents high rate of complications. Unexpandable stent is one of the most serious complication. Both of these conditions may benefit from the intracoronary lithotripsy (ICL-Shockwave®), a new coronary percutaneous technique. Case summary This case report describes a man treated with percutaneous coronary intervention (PCI) for a left main (LM) severe calcified lesion. The PCI was complicated by a huge dissection of LM in a not completely expandable lesion. A bail-out stent implantation was performed with residual unexpansion. The ICL permitted to expand acutely the stent and obtain an optimal final result. Discussion Familiarity with dedicated techniques and devices to treat calcified coronary lesions is fundamental to perform high-risk complex PCI. This case emphasizes the potential usefulness of the new ICL technique to treat calcified lesions or related complications like unexpandable stent.

scholarly journals PCI IN PATIENT WITH HEAVY CALCIFIED LESION. MANAGEMENT AND BALLOON RUPTURE COMPLICATION

2016 ◽  
Vol 51 (4) ◽  
pp. 257
Author(s):  
Yudi Her Oktaviono
Keyword(s):  
High Pressure ◽  
Balloon Angioplasty ◽  
Interventional Cardiology ◽  
Cutting Balloon ◽  
Technical Challenge ◽  
Angioplasty Balloon ◽  
Calcified Lesion ◽  
Novel Approaches ◽  
Coronary Lesions ◽  
Calcified Coronary Lesions

Balloon angioplasty in calcified coronary lesions may have a decreased success rate and an increased incidence of complications. This lesion remain a technical challenge in interventional cardiology despite novel approaches and devices. We describe a case with heavy calcified coronary lesion in LAD that was not only resistant to high-pressure inflation of conventional, non-compliant balloons and cutting balloon but the inflations also results in balloon rupture. Even, the first balloon became fracture and entrapment in LAD. The fractured balloon could be removed using second baloon inflation in LCX. The angioplasty balloon was successfully performed after rotational atherectomy by rotablator and succesfully continued by implantation stent DES.

Abstract 20162: Comparision of Procedural and 30 Day Outcomes of Roataional vs Orbital Atherectomy in Severely Calcified Coronary Lesions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anitha Rajamanickam ◽  
Usman Baber ◽  
Melissa Aquino ◽  
Swathi Roy ◽  
Annapoorna Kini ◽  
...  
Keyword(s):  
Learning Curve ◽  
Clinical Success ◽  
Percutaneous Treatment ◽  
Side Branch ◽  
Stent Deployment ◽  
Novel Approach ◽  
Orbital Atherectomy ◽  
Coronary Lesions ◽  
Procedural Success ◽  
Calcified Coronary Lesions

Introduction: The percutaneous treatment of heavily calcified coronary lesions remains suboptimal and often requires debulking with Rotational Atherectomy (RA) which is often underutilized due to a steep learning curve. Although a novel approach using Orbital Atherectomy (OA) has been introduced, which has an easier set-up and easier learning curve, a comparative assessment of both techniques in real world cohort has not been performed METHODS: Retrospective analysis of our prospectively collected database between October 2013 to May 2014 for patients undergoing atherectomy in heavily calcified lesions at our center retrieved 105 OA and 196 RA procedures RESULTS: There were no significant differences in patient demographics.The maximal stent diameter was significantly larger in OA vs RA (3.41 mm 2 vs 3.28 mm 2 , p=0.02).There was a trend towards RA showing better Procedural success defined as successful stent deployment with TIMI 3 flow ( 95.9% vs 90.5%, p = 0.06) and Clinical Success which is procedural success without death, stroke or CABG ( 95.9% vs 90.5%, p = 0.06). Two cases of failed initial OA underwent successful RA. Procedural complications (≥ grade 3 dissection, side branch closure, perforation, slow flow/no flow or vessel closure), In-hospital MACE (a composite of death, stroke, CABG or CKMB>5X), 30 day readmission rates and 30 day MACE were not statistically significant[See Table 1 and Figure 1]. CONCLUSION: OA demonstrated a similar safety and efficacy profile to RA with a trend towards lower procedural success but comparable complications and 30 day outcomes, suggesting OA may serve as an alternative to RA in PCI of heavily calcified lesions.

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