Low Speed Rotational Angioplasty in Chronic Coronary Artery Obstructions

Kaltenbach, M; Vallbracht, C.

doi:10.1007/978-3-662-12117-7_7

Cited by 3 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This wire has been used with a 62% success rate in the initial 60 consecutive total occlusion PTCA attempts by its developers. High [24] and low [25] speed rotational catheters have been used with some success for chronic occlusions of peripheral and coronary arteries respectively. A hot tip "laser wire" was used to recanalize six chronic total coronary occlusions that could not be crossed by conventional means (Sanborn TA and Cumberland DC, unpublished results) [26].…”

Section: New Technologymentioning

confidence: 99%

Angioplasty of a totally occluded right coronary artery

Taylor

Vetrovec

1992

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

We have presented a case of angioplasty of a chronically occluded right coronary artery. The occlusion had been present for 6 wks by clinical estimates. The length of the occluded segment (approximately 55 cm) did not preclude a successful outcome. Proper selection and manipulation of angioplasty equipment are, as in every case, critical for procedural success. Subintimal guidewire passage, though a frequent event, is occasionally associated with ischemic manifestations, and mandates detection and proper management. New approaches to PTCA of total coronary occlusions continue to be developed.

show abstract

Section: New Technologymentioning

confidence: 99%

Angioplasty of a totally occluded right coronary artery

Taylor

Vetrovec

1992

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

show abstract

“…A low‐speed rotational device has been used to re‐canalise totally occluded coronary arteries 73 . This metal coil and plastic catheter system creates a passage across an occluded coronary segment before a standard balloon angioplasty procedure is carried out, but confirmation of the initial promising results is awaited.…”

Section: Novel Interventional Techniquesmentioning

confidence: 99%

Coronary Intervention: Where Are We Now?

Henderson

1992

Int J Clinical Practice

View full text Add to dashboard Cite

SUMMARYCoronary interventional techniques are used widely in the treatment of patients with coronary artery disease. With modern dilatation equipment the angiographic success rate of coronary balloon angioplasty may exceed 90%, but complications due to acute coronary occlusion may require emergency coronary artery bypass surgery (2 – 4%), or result in acute myocardial infarction (2 – 5%) or in‐hospital death (0 – 2%). In most patient groups the long‐term outcome of successful coronary angioplasty is good, but restenosis of a successfully dilated stenosis occurs in about 30% of cases, necessitating re‐intervention in a significant proportion of patients.Other interventional methods of treating coronary artery stenosis, including directional and rotational coronary atherectomy, endoluminal stenting, and laser angioplasty, have been used in preliminary clinical studies. The acute results of these techniques are encouraging but the restenosis rate remains high and the long‐term results are uncertain. The results of randomised clinical trials comparing coronary interventional techniques with alternative treatment methods are awaited.

show abstract

“…The slow rotational atheroablation device used by Kaltenbach and Vallbracht is a mechanical device that has shown potential as a safe method for recanalization of both coronary and peripheral total occlusions. This device consists of a flexible stainless-steel catheter with a very small blunt tip rotated by an electric motor at 200 rpm [136,137]. The device is advanced through a guiding catheter to the site of total occlusion and then advanced slowly while slow rotation is continued.…”

Section: Other Mechanical Devicesmentioning

confidence: 99%

“…The device is advanced through a guiding catheter to the site of total occlusion and then advanced slowly while slow rotation is continued. In a series of 60 total coronary occlusions that were not crossed by conventional guidewires this device successfully crossed approximately 60% of the lesions [137]. Since this device only creates a small luminal channel, all of these lesions were then dilated by using conventional balloon angioplasty techniques.…”

Section: Other Mechanical Devicesmentioning

confidence: 99%

New technologies for the treatment of obstructive arterial disease

Fischell

Stadius

1991

Cathet. Cardiovasc. Diagn.

View full text Add to dashboard Cite

The well-known limitations of balloon angioplasty include unpredictable abrupt closure, chronic total occlusion, diffuse disease, and restenosis, among other factors. These limitations have prompted the development of new technologic approaches to angioplasty including laser applications for plaque ablation, mechanical device applications for plaque removal/debridement, and stent devices for structural maintenance of vascular lumen patency. Devices which directly apply laser energy for ablation of plaque material include a balloon-centered laser angioplasty system, excimer laser ablation catheter systems, and a fluorescence-guided spectral feedback laser system. Experience with these devices indicates that plaque can be successfully ablated by using laser energy. Vessel perforation and dissection are complications reported with these devices and the effects of laser angioplasty on restenosis remain unclear. Indirect application of laser energy has been tested by using a "hot tip" catheter and a laser balloon angioplasty system. Although the hot tip device has received FDA approval for use in peripheral arteries, it appears to have very limited applications in the coronary arteries. Laser balloon angioplasty appears to be beneficial in the setting of threatened acute closure; the device continues to be evaluated for potential beneficial impact on restenosis. Mechanical atherectomy catheters are designed to remove atherosclerotic plaque from the arterial system and include the AtheroCath, the Transluminal Extraction Catheter (TEC), and the Pullback Atherectomy Catheter (PAC). The Rotablator is an atheroablation device which debrides the obstructing plaque material with distal embolization of the particulate debris. Successful removal/debridement of atherosclerotic plaque has been demonstrated with the AtheroCath, Rotablator, and the TEC device. Pre-clinical studies demonstrate successful removal of plaque material with the PAC device. Despite the theoretic advantage of removing plaque material when performing angioplasty with these devices, there has been little or no reduction in restenosis rates based on a significant experience with the AtheroCath and the Rotablator. Intravascular stent devices including one self-expanding device design and two balloon-expandable device designs have been employed successfully in the elective setting to treat recurrent restenosis lesions. Two of the devices have been successfully tested in the setting of threatened acute closure. Early follow-up studies suggest some improvement in restenosis rates in certain clinical settings following intravascular stenting. Acute and subacute thrombosis remain substantial problems for stent devices and very aggressive anticoagulation regimens are necessary to minimize the adverse events. In summary, a number of a new technologic approaches for treatment of atherosclerotic lesions have been developed and are undergoing significant clinical evaluation.(ABSTRACT TRUNCATED AT 400 WORDS)

show abstract

Low Speed Rotational Angioplasty in Chronic Coronary Artery Obstructions

Cited by 3 publications

References 0 publications

Angioplasty of a totally occluded right coronary artery

Angioplasty of a totally occluded right coronary artery

Coronary Intervention: Where Are We Now?

New technologies for the treatment of obstructive arterial disease

Contact Info

Product

Resources

About