Orbital atherectomy for symptomatic lower extremity disease

Korabathina, Ravikiran; Mody, Kanika; Yu, Jennie; Han, Seol Young; Patel, Ruchika; Staniloae, Cezar

doi:10.1002/ccd.22508

Cited by 33 publications

(23 citation statements)

References 18 publications

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“…The addition of verapamil 5 mg and nitroglycerin 5 mg in the saline bag may help reduce spasm. In a recent study evaluating the safety and efficacy of the DB360 system, the incidence of spasm was 3% and resulted in no clinical sequellae or resolved subsequently [12].…”

Section: Arterial Spasmmentioning

confidence: 98%

Optimal Techniques with the Diamondback 360° System Achieve Effective Results for the Treatment of Peripheral Arterial Disease

Adams

Khanna

Staniloae

et al. 2011

J. of Cardiovasc. Trans. Res.

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The Diamondback 360® Orbital PAD System (DB360) is a novel orbital atherectomy system for the treatment of calcified lower extremity lesions associated with peripheral arterial disease (PAD). This percutaneous, endovascular system incorporates the use of centrifugal force and differential sanding to modify plaque morphologies. The mechanism of differential sanding discriminates between compliant arterial tissue and diseased fibro-calcific or calcific plaque. An eccentrically mounted diamond-coated crown orbits at high speeds and removes a thin layer of calcific plaque with each pass of the crown. The crown creates a more concentric, smooth vessel lumen with increased diameter, increased lesion compliance and improved blood flow while protecting the vessel media. As a result, the risk for post-procedure thrombus formation and potential for restenosis may be reduced. The risk of intra-procedural events (slow flow, hemolysis, spasm and pain) may be reduced due to the design of this orbital sanding system along with proper technique. Extensive benchtop, in vivo, and clinical testing has confirmed these results and is presented within this paper. In addition, guidelines for selecting the most appropriate crown size and type (solid versus classic) and step-by-step procedural technique and pharmacology information are presented. The DB360 System provides a safe, efficacious, and cost-effective endovascular method for PAD treatment. Careful understanding of procedural methods, use of pharmacological drugs, and understanding of device operation contributes to improved treatment success.

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Section: Arterial Spasmmentioning

confidence: 98%

Optimal Techniques with the Diamondback 360° System Achieve Effective Results for the Treatment of Peripheral Arterial Disease

Adams

Khanna

Staniloae

et al. 2011

J. of Cardiovasc. Trans. Res.

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“…As for Rotablator (see Section 4.2.1), cooling is mandatory (it is obtained by saline infusion) and most debris are smaller than RBCs. A few cases of distal embolization and haemolysis were reported (Korabathina et al 2010); to limit these critical effects, treatment duration should not exceed 6 min with 30 s maximum of continuous cutting.…”

Section: Orbital Atherectomymentioning

confidence: 99%

Removing vascular obstructions: a challenge, yet an opportunity for interventional microdevices

Miloro

Sinibaldi

Menciassi

et al. 2012

Biomed Microdevices

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Cardiovascular diseases are the leading cause of death worldwide; they are mainly due to vascular obstructions which, in turn, are mainly caused by thrombi and atherosclerotic plaques. Although a variety of removal strategies has been developed for the considered obstructions, none of them is free from limitations and conclusive. The present paper analyzes the physical mechanisms underlying state-of-art removal strategies and classifies them into chemical, mechanical, laser and hybrid (namely chemo-mechanical and mechano-chemical) approaches, while also reviewing corresponding commercial/research tools/devices and procedures. Furthermore, challenges and opportunities for interventional micro/nanodevices are highlighted. In this spirit, the present review should support engineers, researchers active in the micro/nanotechnology field, as well as medical doctors in the development of innovative biomedical solutions for treating vascular obstructions. Data were collected by using the ISI Web of Knowledge portal, buyer's guides and FDA databases; devices not reported on scientific publications, as well as commercial devices no more for sale were discarded. Nearly 70% of the references were published since 2006, 55% since 2008; these percentages respectively raise to 85% and 65% as regards the section specifically reviewing state-of-art removal tools/devices and procedures.

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“…41) Literature has emerged regarding the role of primary atherectomy for femoropopliteal disease. Despite the different types of atherectomy devices (laser, directional, orbital), [42][43][44][45][46][47] there remain concerns regarding the risk of distal embolic debris and restenosis with this strategy. Publications of larger prospective multicenter trials are needed to highlight the role of atherectomy in femoropopliteal arteryial disease.…”

Section: Endovascular Interventionmentioning

confidence: 99%

An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)

Jaff

White

Hiatt

et al. 2015

Annals of Vascular Diseases

134

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Orbital atherectomy for symptomatic lower extremity disease

Abstract: Orbital atherectomy allows for a significant procedural success, limited need for stenting, and favorable safety profile.

Cited by 33 publications

References 18 publications

Optimal Techniques with the Diamondback 360° System Achieve Effective Results for the Treatment of Peripheral Arterial Disease

Optimal Techniques with the Diamondback 360° System Achieve Effective Results for the Treatment of Peripheral Arterial Disease

Removing vascular obstructions: a challenge, yet an opportunity for interventional microdevices

An Update on Methods for Revascularization and Expansion of the TASC Lesion Classification to Include Below-the-Knee Arteries: A Supplement to the Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II)

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