Severely calcified coronary stenoses: novel challenges, old remedy

Gioia, Giuseppe Di; Morisco, Carmine; Barbato, Emanuele

doi:10.5114/aic.2018.76400

Cited by 2 publications

(2 citation statements)

References 7 publications

(9 reference statements)

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“…Moreover, it has to be mentioned that remaining in line with current trends, femoral, instead of radial access, has become a minority. This was also indicated in one of the previously published papers analyzing Polish patients treated with RA and other reports [10, 11] was and was also not reflected in the increased rate of procedure-related complications, which was stable in the last 3 years of the present analysis and was around 3%. It should be noted that most of the previously published registers concerned significantly smaller groups of patients, and their analysis included complications from the entire hospitalization period and not only from the stay in the catheterization room.…”

Section: Discussionsupporting

confidence: 79%

Current trends and procedural outcomes in the era of rotational atherectomy expansion in Poland in the period 2014–2017 (based on the nationwide ORPKI registry)

Januszek¹,

Siudak²,

Reczuch³

et al. 2019

pwki

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Introduction The availability of rotational atherectomy (RA) has recently increased in Poland, which was followed by an increase in the rate of RA procedures and catheterization laboratories performing RA. Aim To assess current trends regarding the rapid increase in the number of RA procedures and catheterization laboratories performing RA. Material an methods We analyzed patients treated with percutaneous coronary intervention (PCI) in the years 2014–2017 available in the nationwide ORPKI dataset. From the overall 431,467 patients treated with PCI, we extracted 1,873 treated with RA. We analyzed the relationship between frequency of RA usage, its distribution between low and high volume centers and procedural outcomes, procedural-related complications and the PCI effectiveness expressed as the target vessel patency rate after PCI. Results The number of RA procedures increased from 181 in 2014 (0.19%) to 698 in 2017 (0.61%), with an over two-fold increase in the number of catheterization laboratories performing RA from 25 (15.5%) in 2014 to 55 (34.1%) in 2017. Besides the fact that patient characteristics have changed in the most recent years, the rate of procedural success expressed as procedure-related complications remained stable in the 3 years 2015–2017 and was around 3%, while the procedural effectiveness expressed as patent target coronary artery after PCI was stable and over 98% in all of the analyzed years. Conclusions Along with the increasing number of RA procedures and catheterization laboratories performing RA in Poland, the procedural effectiveness remained stable during an observational period of 4 years.

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Section: Discussionsupporting

confidence: 79%

Current trends and procedural outcomes in the era of rotational atherectomy expansion in Poland in the period 2014–2017 (based on the nationwide ORPKI registry)

Januszek¹,

Siudak²,

Reczuch³

et al. 2019

pwki

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“…6 Various devices and techniques are introduced to facilitate the stent, including the mother-in-child technique, rotational atherectomy, and anchor balloon technique. 7,8 However, these devices and methods are expensive, associated with an increased risk of complications (acute vessel closure, perforation, and equipment loss or entrapment), not always available, and may not be feasible for specific situations. Therefore, a relatively simple, reproducible, and inexpensive technique is needed to overcome this problem.…”

mentioning

confidence: 99%

A Practical Technique to Advance Stent Through Uncrossable Coronary Lesions: A Prospective Cohort Study

ALYAN,

SÜMERKAN,

KESKİN

et al. 2023

Turkiye Klinikleri J Cardiovasc Sci

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Uncrossable coronary lesions are still challenging to treat. Several devices and techniques are introduced, including rotational atherectomy, or anchor balloon. However, these methods are expensive, not always available, and associated with lower procedural success and higher major adverse cardiac events. Our study describes a simple, effective method [patience technique (PT)] to advance a stent through uncrossable lesions that has not been described in the literature. Material and Methods: In a prospective study with 24 patients undergoing uncrossable lesion percutaneous coronary intervention with stent advancement failures, we identify PT and describe our experience with PT. The PT is the process of pushing the uncrossed same stent for a prolonged time under an optimum constant force to overcome the intraluminal friction. Results: Twenty-three (95.8%) patients had modified American College of Cardiology/ American Heart Association classification Type C, 22 (91.70%) diffuse [median length: 38 mm (quartiles 31.25-52.25)], 22 (91.70%) eccentric and 20 (83.30%) moderate-extensive calcified lesions. Respectively, 8 (27.59%) of 29 stenosis was in left anterior descending, and right coronary artery, 6 (20.69%) left circumflex coronary artery, 3 (10.35%) D1, 2 (6.90%) left main coronary artery-Cx, 1 (3.45%) LCxOM2 and saphenous vein graft-LCxOM2. The median stent advancement time was 134.00 seconds (quartiles 95.25-178.50). All procedures progressed after using the PT and finally resulted successfully without complications. Conclusion: The PT is feasible, and safe for facilitating the passage of stents through uncrossable lesions. Before advancing percutaneous cardiac intervention techniques, this method could be used advantageously in calcified, diffuse, and eccentric lesions.

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Severely calcified coronary stenoses: novel challenges, old remedy

Cited by 2 publications

References 7 publications

Current trends and procedural outcomes in the era of rotational atherectomy expansion in Poland in the period 2014–2017 (based on the nationwide ORPKI registry)

Current trends and procedural outcomes in the era of rotational atherectomy expansion in Poland in the period 2014–2017 (based on the nationwide ORPKI registry)

A Practical Technique to Advance Stent Through Uncrossable Coronary Lesions: A Prospective Cohort Study

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