Rotational atherectomy to left circumflex ostial lesions: tips and tricks

Taniguchi, Yousuke; Sakakura, Kenichi; Jinnouchi, Hiroyuki; Tsukui, Takunori; Fujita, Hideo

doi:10.1007/s12928-023-00941-y

Cited by 5 publications

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rotational atherectomy (RA) has been the cornerstone for the percutaneous coronary intervention (PCI) to severely calcified lesions [ 1 – 5 ]. Among severely calcified lesions, RA is technically more difficult in a diffuse long calcified lesion than in a focal short calcified lesion, because the lesion length is closely associated with the occurrence of complications during RA [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Halftime rotational atherectomy: a unique concept for diffuse long severely calcified lesions

Sakakura,

Jinnouchi,

Taniguchi

et al. 2023

Cardiovasc Interv and Ther

Self Cite

View full text Add to dashboard Cite

Rotational atherectomy (RA) is technically more difficult in a diffuse calcified lesion than in a focal calcified lesion. We hypothesized that taking a halftime can be another option for RA to the diffuse calcified lesions. Halftime was defined as at least one long break during RA, in which an operator pulled out the Rotablator system from the guide catheter before crossing the lesion. This study aimed to compare the complications between RA with and without halftime. We included 177 diffuse long severely calcified lesions (lesion lengths ≥ 30 mm) that required RA, and divided those lesions into a halftime group (n = 29) and a no-halftime group (n = 148). The primary outcome was periprocedural myocardial infarction (MI). The reference diameter was smaller in the halftime group than in the no-halftime group [1.82 (1.70–2.06) mm versus 2.17 (1.89–2.59) mm, p = 0.002]. The total run time was longer in the halftime group than in the non-halftime group [133.0 (102.0–223.0) seconds versus 71.5 (42.0–108.0) seconds, p < 0.001]. Although creatinine kinase (CK) and CK–myocardial band (MB) was significantly higher in the halftime group than in the no-halftime group [CK: 156 (97–308) U/L versus 99 (59–216) U/L, p = 0.021; CK–MB: 15 (8–24) U/L versus 5 (3–15) U/L, p < 0.001], periprocedural MI was not observed in the halftime group. In conclusion, periprocedural MI was not observed in RA with halftime. This preliminary study suggests that halftime RA may be a safe option for diffuse severely calcified lesions. Graphical abstract

show abstract

Section: Introductionmentioning

confidence: 99%

Halftime rotational atherectomy: a unique concept for diffuse long severely calcified lesions

Sakakura,

Jinnouchi,

Taniguchi

et al. 2023

Cardiovasc Interv and Ther

Self Cite

View full text Add to dashboard Cite

show abstract

Antithrombotic management in atrial fibrillation patients following percutaneous coronary intervention: A clinical review

Saito,

Kobayashi

2024

Journal of Arrhythmia

View full text Add to dashboard Cite

Patients with atrial fibrillation (AF) often develop acute coronary syndrome and undergo percutaneous coronary intervention (PCI), and vice versa. Acute coronary syndrome and PCI mandate the use of dual antiplatelet therapy, while oral anticoagulation is recommended in patients with AF to mitigate thromboembolic risks. Clinical evidence concerning antithrombotic treatment in patients with AF and PCI has been accumulated, but when combined, the therapeutic strategy becomes complex. Although triple therapy, a combination of oral anticoagulation with dual antiplatelet therapy, has been used for patients with AF undergoing PCI as an initial antithrombotic strategy, less intensive regimens may be associated with a lower rate of bleeding without an increased risk in thrombotic events. This narrative review article summarizes currently available evidence of antithrombotic therapy in patients with AF undergoing PCI.

show abstract

Impact of stent strut link location in proximal balloon edge dilation technique for bifurcation percutaneous coronary intervention

Kume,

Nishi,

Murasato

et al. 2024

Cardiovasc Interv and Ther

View full text Add to dashboard Cite

The single-stent strategy has generally been accepted as the default approach to bifurcation percutaneous coronary intervention. We have proposed the proximal balloon edge dilation (PBED) technique to prevent stent deformation during side branch (SB) dilation. This bench study aimed to evaluate the impact of stent link location and stent design on stent deformation, obstruction by stent struts at a jailed SB ostium, and incomplete stent apposition in the proximal optimization technique (POT)-PBED procedure. A coronary bifurcation model was used. We intentionally set the absence or presence of stent link on the carina (link-free or link-connect) under videoscope observation and compared stent parameters between 3- and 2-link stents (n = 5 each, n = 20 total). In the link-free group, the SB jailing rate of 3-link stents was significantly higher than that of 2-link stents (15.5 ± 5.1% vs. 6.6 ± 1.2%, p = 0.009). In the link-connect group, the SB jailing rate of 3-link stents was significantly lower than that of 2-link stents (30.0 ± 4.5% vs. 39.0 ± 2.6%, p = 0.009). In the bifurcation segment, the rate of incomplete stent apposition was significantly lower for 3-link stents of the link-connect group than for 2-link stents of the link-connect group (3.3 ± 4.2% vs. 19.0 ± 7.8%, p = 0.009). For both stent designs, ellipticity ratio was higher for link-connect group than link-free group. Link location as well as stent cell design greatly impacted stent deformation during the POT-PBED procedure. Graphical abstract

show abstract

Rotational atherectomy to left circumflex ostial lesions: tips and tricks

Cited by 5 publications

References 17 publications

Halftime rotational atherectomy: a unique concept for diffuse long severely calcified lesions

Halftime rotational atherectomy: a unique concept for diffuse long severely calcified lesions

Antithrombotic management in atrial fibrillation patients following percutaneous coronary intervention: A clinical review

Impact of stent strut link location in proximal balloon edge dilation technique for bifurcation percutaneous coronary intervention

Contact Info

Product

Resources

About