Intravascular Laser Technologies

Walker, Craig M.

doi:10.1007/978-1-4419-1387-6_18

Cited by 4 publications

(9 citation statements)

References 31 publications

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“…Lesions in the superficial femoral artery constituted the majority (90%) of the treated segments. All lesions were successfully crossed with 2.0-mm Turbo-Elite laser catheter to create the pilot channel and subsequently treated with 8.0 ± 3.9 passes of the Turbo-Booster system which has the capability of going up to 60 mJ/mm at 80 Hz [ 7 ]. The index IVUS analysis was independently performed by the MedStar Research Institute Core Laboratory and there was a close correlation between the IVUS derived increase in lumen diameter and the diameter as measured by angiography.…”

Section: Resultsmentioning

confidence: 99%

Intravascular ultrasound assessment of the effect of laser energy on the arterial wall during the treatment of femoro-popliteal lesions: a CliRpath excimer laser system to enlarge lumen openings (CELLO) registry study

Kuku

García‐García

Koifman

et al. 2017

Int J Cardiovasc Imaging

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The CliRpath Excimer Laser System to Enlarge Lumen Openings (CELLO) registry included patients treated with modified excimer laser catheters for the endovascular treatment of peripheral artery disease affecting the superficial femoral artery (SFA) and proximal popliteal artery. The aim of this study was to assess, via intravascular ultrasound (IVUS) the dissections in the vessel wall following treatment with the laser catheters. IVUS grayscale images from the CELLO registry were systematically reviewed for dissections in the treated vessel segments by two investigators. Images from 33 patients; 66 pullbacks (1867 IVUS frames in 2 phases), were successfully matched frame-to-frame to evaluate identical segments of the treated vessels in the two phases; post-2 mm Turbo-Elite laser pilot channel creation and post Turbo-Booster laser atherectomy. Dissections were categorized as; (1) intimal, (2) medial, (3) intramural hematoma, and (4) adventitial according to the ACC Clinical Expert Consensus Document classification of dissections. An average of 57 frames was evaluated per pullback, giving a total of 3734 frames (1867 matched for pre-ablation (post channel creation) and post-ablation phases). Treatments with the modified Excimer laser catheters resulted in a significant increase in lumen area of 5.5 ± 3.2-mm2 (95% CI 4.3–6.8, p < 0.0001) and reduction in plaque plus media volume of −10.6 ± 36.0 mm3 (95% CI −25.8 to 4.6, p = 0.1619) whilst giving rise to mainly intramural hematoma formations post Turbo-Booster laser treatment in 55% of frames assessed and 24% medial dissections with less than 1% adventitial disruption. The Excimer laser based Turbo-Booster treatment of peripheral artery lesions resulted in significant plaque debulking and increased lumen diameter with negligible degree of adventitial layer injury.

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Section: Resultsmentioning

confidence: 99%

Intravascular ultrasound assessment of the effect of laser energy on the arterial wall during the treatment of femoro-popliteal lesions: a CliRpath excimer laser system to enlarge lumen openings (CELLO) registry study

Kuku

García‐García

Koifman

et al. 2017

Int J Cardiovasc Imaging

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“…In general, guidewire performance is determined by several key features: core, coils/covers, coating, and tip design 1 2 ( Fig. 1 ).…”

Section: Core Coils/covers Coating Tip Designmentioning

confidence: 99%

“…A hybrid wire is sometimes created to include all of the aforementioned features by using a stainless-steel core and a nitinol tip. 1 2 3…”

Section: Core Coils/covers Coating Tip Designmentioning

confidence: 99%

“…Gradual or long tapers are better for accessing a branch arising at an acute angle from the parent vessel and allow the wire to follow without prolapsing out of the branch. Guidewires with abrupt or short tapers tend to have better support over short distances and prolapse easily which is helpful during a subintimal recanalization but not for selecting branches arising at acute angles from the parent vessel 1 2 3 ( Fig. 2 ).…”

Section: Core Coils/covers Coating Tip Designmentioning

confidence: 99%

“…The advantage is more tactile feel but with increased resistance during advancement. Common examples of hydrophobic coatings include silicone and PTFE 1 2 3 ( Figs. 5 and 6 ).…”

Section: Core Coils/covers Coating Tip Designmentioning

confidence: 99%

See 2 more Smart Citations

Basics of Guidewire Technology and Peripheral Artery Disease

Tummala

Shackcloth

2023

Semin intervent Radiol

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Guidewire technology has advanced significantly over the last several decades. As more components are incorporated providing valuable features, deciding which guidewire to use during peripheral artery disease (PAD) interventions has become more complex. The challenge for both the beginner and expert is not only understanding which components offer the best characteristics in a guidewire but choosing the optimal wire for an intervention. Manufacturers have attempted to optimize components to provide physicians with routinely available guidewires needed in everyday practice. Yet selecting the best guidewire for a particular situation during an intervention is still challenging. This article provides a basic overview of guidewire components and what benefits they offer during PAD interventions.

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Crossing Total Occlusions using a hydraulic pressure wave: a feasibility study

Sakes¹,

Nicolai²,

Karapanagiotis³

et al. 2018

Biomed. Phys. Eng. Express

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Crossing highly calcified occlusions is technically challenging mainly due to guidewire buckling. In an effort to prevent buckling, a catheter that uses a dynamic impulse load is proposed. The proposed Wave catheter consists of an input plunger to generate an impulse at the handle, a hydraulic pressure wave confined within a Ø2 mm catheter to transfer the impulse towards the tip, and an output plunger to transfer the impulse to the occlusion. To determine the feasibility of this catheter, an experiment was performed in which the input and output impulses were recorded as a function of the catheter type, curvature, and plunger travel distance. Additionally, the system was tested on artificial CTO models to determine the clinical validity. The catheter has illustrated the ability to safely transfer high-force impulses of up to 43N (1.5 N required) with only minimum catheter type and no curvature dependency, allowing for delivering high-force impulses through tortuous vasculature and under any angle. Furthermore, the catheter was able to penetrate the artificial CTO models within 1 strike.

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Intravascular Laser Technologies

Cited by 4 publications

References 31 publications

Intravascular ultrasound assessment of the effect of laser energy on the arterial wall during the treatment of femoro-popliteal lesions: a CliRpath excimer laser system to enlarge lumen openings (CELLO) registry study

Intravascular ultrasound assessment of the effect of laser energy on the arterial wall during the treatment of femoro-popliteal lesions: a CliRpath excimer laser system to enlarge lumen openings (CELLO) registry study

Basics of Guidewire Technology and Peripheral Artery Disease

Crossing Total Occlusions using a hydraulic pressure wave: a feasibility study

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