Abstract
Introduction: The presence of severe coronary artery calcification is associated with higher rates of angiographic complications during percutaneous coronary intervention (PCI), as well as higher major adverse cardiac events compared with non-calcified lesions. Incorporating orbital atherectomy (OAS) for effective preparation of severely calcified lesions can help maximize the benefits of PCI by attaining maximal luminal gain (or stent expansion) and improve long-term outcomes (by reducing need for revascularization). Areas covered: In this manuscript, the prevalence, risk factors, and impact of coronary artery calcification on PCI are reviewed. Based on current data and experience, the authors review orbital atherectomy technique and best practices to optimize lesion preparation. Expert Commentary: The coronary OAS is the only device approved for use in the U.S. as a treatment for de novo, severely calcified coronary lesions to facilitate stent delivery. Advantages of the device include its ease of use and a mechanism of action that treats bi-directionally, allowing for continuous blood flow during treatment, minimizing heat damage, slow flow, and subsequent need for revascularization. The OAS technique tips reviewed in this article will help inform interventional cardiologists treating patients with severely calcified lesions.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 867-879 |
| Number of pages | 13 |
| Journal | Expert Review of Medical Devices |
| Volume | 14 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 2 2017 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Surgery
- Biomedical Engineering
Cite this
}
Orbital atherectomy for the treatment of severely calcified coronary lesions : evidence, technique, and best practices. / Shlofmitz, Evan; Martinsen, Brad J.; Lee, Michael; Rao, Sunil V.; Genereux, Philippe; Higgins, Joe; Chambers, Jeffrey W.; Kirtane, Ajay J.; Brilakis, Emmanouil S.; Kandzari, David E.; Sharma, Samin K.; Shlofmitz, Richard.
In: Expert Review of Medical Devices, Vol. 14, No. 11, 02.11.2017, p. 867-879.Research output: Contribution to journal › Review article
TY - JOUR
T1 - Orbital atherectomy for the treatment of severely calcified coronary lesions
T2 - evidence, technique, and best practices
AU - Shlofmitz, Evan
AU - Martinsen, Brad J.
AU - Lee, Michael
AU - Rao, Sunil V.
AU - Genereux, Philippe
AU - Higgins, Joe
AU - Chambers, Jeffrey W.
AU - Kirtane, Ajay J.
AU - Brilakis, Emmanouil S.
AU - Kandzari, David E.
AU - Sharma, Samin K.
AU - Shlofmitz, Richard
PY - 2017/11/2
Y1 - 2017/11/2
N2 - Introduction: The presence of severe coronary artery calcification is associated with higher rates of angiographic complications during percutaneous coronary intervention (PCI), as well as higher major adverse cardiac events compared with non-calcified lesions. Incorporating orbital atherectomy (OAS) for effective preparation of severely calcified lesions can help maximize the benefits of PCI by attaining maximal luminal gain (or stent expansion) and improve long-term outcomes (by reducing need for revascularization). Areas covered: In this manuscript, the prevalence, risk factors, and impact of coronary artery calcification on PCI are reviewed. Based on current data and experience, the authors review orbital atherectomy technique and best practices to optimize lesion preparation. Expert Commentary: The coronary OAS is the only device approved for use in the U.S. as a treatment for de novo, severely calcified coronary lesions to facilitate stent delivery. Advantages of the device include its ease of use and a mechanism of action that treats bi-directionally, allowing for continuous blood flow during treatment, minimizing heat damage, slow flow, and subsequent need for revascularization. The OAS technique tips reviewed in this article will help inform interventional cardiologists treating patients with severely calcified lesions.
AB - Introduction: The presence of severe coronary artery calcification is associated with higher rates of angiographic complications during percutaneous coronary intervention (PCI), as well as higher major adverse cardiac events compared with non-calcified lesions. Incorporating orbital atherectomy (OAS) for effective preparation of severely calcified lesions can help maximize the benefits of PCI by attaining maximal luminal gain (or stent expansion) and improve long-term outcomes (by reducing need for revascularization). Areas covered: In this manuscript, the prevalence, risk factors, and impact of coronary artery calcification on PCI are reviewed. Based on current data and experience, the authors review orbital atherectomy technique and best practices to optimize lesion preparation. Expert Commentary: The coronary OAS is the only device approved for use in the U.S. as a treatment for de novo, severely calcified coronary lesions to facilitate stent delivery. Advantages of the device include its ease of use and a mechanism of action that treats bi-directionally, allowing for continuous blood flow during treatment, minimizing heat damage, slow flow, and subsequent need for revascularization. The OAS technique tips reviewed in this article will help inform interventional cardiologists treating patients with severely calcified lesions.
UR - http://www.scopus.com/inward/record.url?scp=85032303680&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85032303680&partnerID=8YFLogxK
U2 - 10.1080/17434440.2017.1384695
DO - 10.1080/17434440.2017.1384695
M3 - Review article
VL - 14
SP - 867
EP - 879
JO - Expert Review of Medical Devices
JF - Expert Review of Medical Devices
SN - 1743-4440
IS - 11
ER -