Rotational Atherectomy or Balloon-Based Techniques to Prepare Severely Calcified Coronary Lesions

Rheude, Tobias; Fitzgerald, Sean; Allali, Abdelhakim; Mashayekhi, Kambis; Gori, Tommaso; Cuculi, Florim; Kufner, Sebastian; Hemetsberger, Rayyan; Sulimov, Dmitriy S.; Rai, Himanshu; Ayoub, Mohamed; Bossard, Matthias; Xhepa, Erion; Fusaro, Massimiliano; Byrne, Robert A.; Richardt, Gert; Kastrati, Adnan; Cassese, Salvatore; Abdel‐Wahab, Mohamed

doi:10.1016/j.jcin.2022.07.034

Cited by 21 publications

(6 citation statements)

References 24 publications

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“…Adequate plaque modification before stenting is critical to procedural and long-term PCI success, as calcifications often preclude adequate stent expansion. Classic balloon-dependent lesion preparation methods often prove inadequate in highly calcified lesions [ 23 , 24 ]. Therefore, several dedicated devices have been developed to achieve proper plaque modification.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Orbital Atherectomy in the All-Comer Population: Mid-Term Results of the Lower Silesian Orbital Atherectomy Registry (LOAR)

Rola,

Włodarczak,

Barycki

et al. 2023

JCM

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Background: Coronary calcifications represent a challenging subset for the interventional cardiologist performing percutaneous coronary intervention (PCI) and are well-established risk factors for adverse outcomes. Adequate plaque modification prior to stent implantation is critical to achieve an optimal outcome following PCI. Recently, a novel orbital atherectomy device has been introduced into clinical practice to modify calcified plaques. We evaluated the mid-term safety and efficacy of OA in a high-risk “all-comers” population. Methods: We evaluated 96 consecutive patients with severely calcified coronary lesions who underwent PCI facilitated by the orbital atherectomy device. Results: In-hospital MACCE was 5.2% without target lesion revascularization. At 6-month follow-up, the MACCE rate was 10.4% with a concomitant TLR rate of 1%. Conclusions: Our mid-term data showed good safety and efficacy of orbital atherectomy as a plaque-modifying tool in an all-comers cohort with severely calcified coronary lesions.

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Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Orbital Atherectomy in the All-Comer Population: Mid-Term Results of the Lower Silesian Orbital Atherectomy Registry (LOAR)

Rola,

Włodarczak,

Barycki

et al. 2023

JCM

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“…However, these interventions are associated with a high risk of strategy failure and coronary artery injury (dissection/perforation). 3 Shockwave IVL (S-IVL) is a novel calcium modification device that emits sonic pressure waves that circumferentially fracture superficial and deep coronary calcific lesions to improve vessel compliance and facilitate stent implantation. The Disrupt CAD I-IV studies emphasized the high procedural success rates and safety of S-IVL in lesion preparation of severely calcified de novo coronary stenoses, paving the way for US Food and Drug Administration approval in these patients.…”

Section: Discussionmentioning

confidence: 99%

Shock and Awe: Successful Revascularization with Intravascular Lithotripsy in Recurrent ST-Elevation Myocardial Infarction Secondary to Stent Under-Expansion

Ponna,

Gonuguntla,

Botta

et al. 2023

Methodist DeBakey Cardiovascular Journal

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“…Intravascular lithotripsy represents a recently introduced strategy (CE mark in 2017) for the treatment of calcified coronary lesions based on the principles of lithotr included and lesion preparation was obtained with rotablation; a modified balloon and a super high-pressure balloon were compared [69]. Of note, strategy success was more frequent with rotablation versus modified balloons and super high-pressure balloons, but clinical outcomes did not differ among groups.…”

Section: Intravasular Litotripsy (Ivl)mentioning

confidence: 99%

“…In this study, Rheude et al sought to compare rotational atherectomy versus balloonbased techniques before drug-eluting stent implantation in severely calcified coronary lesions. Two-hundred patients with available OCT data were included and lesion preparation was obtained with rotablation; a modified balloon and a super high-pressure balloon were compared [69]. Of note, strategy success was more frequent with rotablation versus modified balloons and super high-pressure balloons, but clinical outcomes did not differ among groups.…”

Section: Rotational Atherectomymentioning

confidence: 99%

Current Management of Highly Calcified Coronary Lesions: An Overview of the Current Status

Caiazzo

Mario

Kedhi

et al. 2023

JCM

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The amount of coronary calcium strongly correlates with the degree of atherosclerosis and, therefore, with the rate of future cardiac events. Calcified coronary lesions still represent a challenge for interventional cardiologists, bringing not only a higher risk of immediate complications during percutaneous coronary interventions (PCI), but also a higher risk of late stent failure due to under-expansion and/or malapposition, and therefore, have a relevant prognostic impact. Accurate identification of the calcified plaques together with the analysis of their distribution pattern within the vessel wall by intracoronary imaging is important to improve the successful treatment of these lesions. The aim of this review is to guide readers through the assessment of the calcified plaque distribution using intracoronary imaging in order to select the best devices and strategies for plaque debulking and lesion preparation.

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Rotational Atherectomy or Balloon-Based Techniques to Prepare Severely Calcified Coronary Lesions

Cited by 21 publications

References 24 publications

Safety and Efficacy of Orbital Atherectomy in the All-Comer Population: Mid-Term Results of the Lower Silesian Orbital Atherectomy Registry (LOAR)

Safety and Efficacy of Orbital Atherectomy in the All-Comer Population: Mid-Term Results of the Lower Silesian Orbital Atherectomy Registry (LOAR)

Shock and Awe: Successful Revascularization with Intravascular Lithotripsy in Recurrent ST-Elevation Myocardial Infarction Secondary to Stent Under-Expansion

Current Management of Highly Calcified Coronary Lesions: An Overview of the Current Status

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