Indications and outcomes of excimer laser coronary atherectomy: Efficacy and safety for thrombotic lesions—The ULTRAMAN registry

Nishino, Masami; Mori, Nobuhiro; Takiuchi, Shin; Shishikura, Daisuke; Doi, Nobuhide; Kataoka, Toru; Ishihara, Takayuki; Kinoshita, Noriyuki

doi:10.1016/j.jjcc.2016.05.018

Cited by 47 publications

(26 citation statements)

References 25 publications

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“…Previous studies have shown the safety and efficacy of ELCA compared with manual thrombus aspiration. The Japanese ULTRAMAN registry showed that ELCA was effective and safe even for the thrombotic lesions [19]. However, previous studies have not evaluated the effects of excimer laser catheter size.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 0.9-mm and 1.4-mm catheters in excimer laser coronary angioplasty for acute myocardial infarction

et al. 2019

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Excimer laser coronary angioplasty (ELCA) is a unique revascularization modality that can vaporize plaque and thrombus. Compared to thrombus aspiration therapy, ELCA is reported to provide better microcirculation and reduced peripheral embolism in treatment for acute coronary syndrome. Excimer laser catheters come in various sizes, and we sought to compare the 0.9-and 1.4-mm-diameter catheters. We retrospectively enrolled 90 acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention with excimer laser from August 2013 to March 2017 in our hospital. Patients were grouped by diameter of catheter that had been used, the 0.9 mm group (n = 51) and 1.4 mm group (n = 39). We evaluated myocardial perfusion, procedural success rate, short-term outcome, lesion crossability, and complications between the two groups. The percentage of patients whose final thrombolysis in myocardial infarction (TIMI) grade was 3 (0.9 mm 86.3% vs 1.4 mm 89.7% p = 0.75) and final myocardial blush grade (MBG) was 3 (0.9 mm 72.5% vs 1.4 mm 69.2% p = 0.82) was similarly high for both groups. Procedural success rate, in-hospital major adverse cardiac events (MACE), lesion crossability, and complications were also similar. This study showed that efficacy of 0.9 and 1.4 mm excimer laser catheter was equivalent in ELCA for AMI patients. If one takes into account lesion crossability, debulking effects, and the stunned platelets phenomenon, the 0.9 mm excimer laser catheter is sufficient for ELCA in AMI patients.

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Section: Discussionmentioning

confidence: 99%

Comparison of 0.9-mm and 1.4-mm catheters in excimer laser coronary angioplasty for acute myocardial infarction

et al. 2019

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“…The current techniques of CTO PCI are intrinsically distinct from conventional PCI for non-occluded vessels [3,27,28]. Although several reports have demonstrated the improvement of LV function as a result of opening an occluded artery, no reports have shown a detailed breakdown of the utilization of modern techniques of CTO PCI.…”

Section: Contemporary Techniques Of Cto Pcimentioning

confidence: 99%

Prediction of functional recovery after percutaneous coronary revascularization for chronic total occlusion using late gadolinium enhanced magnetic resonance imaging

Nakatani

Kato

Kirigaya

et al. 2017

Journal of Cardiology

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“…Currently, the ELCA is used in procedures requiring appropriate tissue ablation, such as acute coronary syndromes, extensive coronary thrombosis, in-stent restenosis, saphenous vein grafts, chronic total occlusions, poorly expanded stents, and calcified lesions. [2][3][4][11][12][13][14] There are no absolute coronary contraindications for the ELCA. The main complications of ELCA are similar to those seen in other types of atherectomy.…”

Section: Discussionmentioning

confidence: 99%

Management of in-stent restenosis of the left main coronary artery with laser atherectomy guided by intracoronary optical coherence tomography

Dallan¹,

Pereira²,

Bezerra³

2019

J Transcat Intervent

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We describe the case of a patient with multiple comorbidities scheduled to undergo intracoronary optical coherence tomography-guided percutaneous coronary intervention. Based on the images acquired, it was possible to observe the mechanism of restenosis and the anatomy of the lesion, and to optimize planning of the procedure. Our strategy was to resect the neointimal hyperplastic tissue using laser atherectomy, with great results and a successful procedure.RESUMO -Descrevemos o caso de um paciente com múltiplas comorbidades, que seria submetido à intervenção coronária percutânea guiada por tomografia de coerência óptica intracoronariana e, de acordo com as imagens obtidas, pudemos observar o mecanismo de reestenose, a anatomia da lesão e o planejamento do procedimento de forma otimizada. Optamos por estratégia de ressecção tecidual de hiperplasia neointimal com aterectomia a laser, com ótimo resultado e sucesso do procedimento.

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Indications and outcomes of excimer laser coronary atherectomy: Efficacy and safety for thrombotic lesions—The ULTRAMAN registry

Abstract: In Japan, the major indications for ELCA have been ACS and ISR. ELCA can provide a safe and effective treatment even for RT lesions.

Cited by 47 publications

References 25 publications

Comparison of 0.9-mm and 1.4-mm catheters in excimer laser coronary angioplasty for acute myocardial infarction

Comparison of 0.9-mm and 1.4-mm catheters in excimer laser coronary angioplasty for acute myocardial infarction

Prediction of functional recovery after percutaneous coronary revascularization for chronic total occlusion using late gadolinium enhanced magnetic resonance imaging

Management of in-stent restenosis of the left main coronary artery with laser atherectomy guided by intracoronary optical coherence tomography

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