Uso de aterectomía coronaria con LASER Excimer como terapia coadyuvante en intervencionismo coronario percutáneo

Ocaranza-Sánchez, Raymundo; Galvão-Braga, C; Trillo-Nouche, Ramiro; González-Juanatey, José Ramón

doi:10.1016/j.recesp.2016.04.030

Cited by 8 publications

(5 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is, therefore, an effective form of atherectomy for complex coronary lesions. 2,3 The use of laser atherectomy is not recent, and it was widely employed in the 1980's as an exclusive intervention to treat coronary lesions. 5,6 However, the use of this type of atherectomy was dramatically reduced in the 1990's due to high restenosis rates, varying from 48% to 57%, resulting from the use of the technique alone, without stenting .…”

Section: Discussionmentioning

confidence: 99%

“…The concept of "tissue photoablation" by ELCA consists of using light to break, vaporize and remove tissues, in a process mediated by three different mechanisms: photochemical, photothermal and photomechanical. [1][2][3] Ultraviolet laser light is absorbed by the intravascular material and breaks carbon-carbon bonds (photochemical). The application of high-energy light raises the temperature of intracellular water, leading to cell rupture and formation of a steam bubble on the tip of the catheter (photothermal).…”

Section: Discussionmentioning

confidence: 99%

“…10 The safety and efficacy of the ELCA are well established, particularly for management of complex lesions requiring appropriate neointimal resection. [1][2][3][4] However, since the use of this technique is restricted in our country, due to the high cost of atherectomy devices in general, as well as to the lack of knowledge about new pieces of equipment and favorable outcomes of the current technique, national data regarding its use are still scarce.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the ELCA is used in procedures requiring appropriate tissue ablation, such as acute coronary syndromes, extensive coronary thrombosis, in-stent restenosis, saphenous vein grafts, chronic total occlusions, poorly expanded stents, and calcified lesions. [2][3][4][11][12][13][14] There are no absolute coronary contraindications for the ELCA. The main complications of ELCA are similar to those seen in other types of atherectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Excimer laser coronary atherectomy (ELCA) is an adjuvant procedure to percutaneous coronary intervention (PCI), aimed to properly preparing the coronary lesion for optimized stenting. 1 It is an effective form of atherectomy for complex coronary lesions, 2,3 and has been gaining space in the management of lesions that require appropriate ablation, like in-stent restenosis and chronic coronary occlusions. 2,4 We describe a case of a PCI guided by intracoronary optical coherence tomography (OCT), using laser atherectomy.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Management of in-stent restenosis of the left main coronary artery with laser atherectomy guided by intracoronary optical coherence tomography

Dallan¹,

Pereira²,

Bezerra³

2019

J Transcat Intervent

View full text Add to dashboard Cite

We describe the case of a patient with multiple comorbidities scheduled to undergo intracoronary optical coherence tomography-guided percutaneous coronary intervention. Based on the images acquired, it was possible to observe the mechanism of restenosis and the anatomy of the lesion, and to optimize planning of the procedure. Our strategy was to resect the neointimal hyperplastic tissue using laser atherectomy, with great results and a successful procedure.RESUMO -Descrevemos o caso de um paciente com múltiplas comorbidades, que seria submetido à intervenção coronária percutânea guiada por tomografia de coerência óptica intracoronariana e, de acordo com as imagens obtidas, pudemos observar o mecanismo de reestenose, a anatomia da lesão e o planejamento do procedimento de forma otimizada. Optamos por estratégia de ressecção tecidual de hiperplasia neointimal com aterectomia a laser, com ótimo resultado e sucesso do procedimento.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Management of in-stent restenosis of the left main coronary artery with laser atherectomy guided by intracoronary optical coherence tomography

Dallan¹,

Pereira²,

Bezerra³

2019

J Transcat Intervent

View full text Add to dashboard Cite

show abstract

Study on the mechanism of thrombus ablation in vitro by burst‐mode femtosecond laser

Zhang

Liu

et al. 2022

Journal of Biophotonics

View full text Add to dashboard Cite

The burst‐mode femtosecond laser has the potential to be a novel thrombus removal technique. This paper proposed to investigate the mechanism of thrombus ablation in vitro by burst‐mode femtosecond laser. A simulation model of the interaction between femtosecond laser and thrombus was established. An in vitro thrombus model was prepared. Combined with the high‐speed galvanometer and femtosecond laser, the ablation experiments in vitro were performed. The experimental results showed that the ablative threshold was 0.27 times and the efficiency was about 1.4 times of burst‐mode femtosecond laser as those of traditional mode femtosecond laser. These phenomena were related to the residual temperature and free electrons on the thrombus surface, which confirmed the simulating results and had relationship with incubation effects. The high ablative efficiency and safety of burst‐mode femtosecond laser for thrombus ablation were verified, which may help to achieve the femtosecond pulse output through flexible fiber easily and stably. The burst‐mode femtosecond laser represents an important technological advancement of the method in terms of endovascular treatment with femtosecond laser.

show abstract

Bioresorbable vascular scaffolds in coronary chronic total occlusions revascularization: safety assessment related to struts coverage and apposition in 6-month OCT follow-up

et al. 2017

View full text Add to dashboard Cite

Beneficial properties of bioresorbable vascular scaffolds (BVS) regarding to vasomotility restoration and no caging of the vessel make them attractive devices in chronic total occlusions (CTO) revascularization. However, more evidence is needed attending to their use in this specific setting. We aim to determine feasibility and safety of BVS use in CTO revascularization attending to struts coverage and apposition, as well as re-stenosis and stent thrombosis (ST) rates. 29 BVS were deployed in 9 CTO lesions revascularization (mean J-CTO score ≥3) with an acute procedural success rate of 100%. Clinical and angiographic follow-up was performed 6 months later, including intracoronary analyses from optical coherence tomography (OCT) images. 44,723 struts were analyzed within the total 636 mm of scaffolded vessel. Mean length scaffolded per lesion was 70.66 ± 31.01 mm with a mean number of 3.22 BVS. 2051 struts (4.59%) were identified as uncovered, being most of them (98.4%) neither malapposed nor disrupted. Mean thickness of struts' coverage was 0.13 ± 0.05 mm. Incomplete strut apposition (ISA) percentage was 0% as no malapposed struts were detected and 134 struts were identified as disrupted, which represents a 0.29% from the total. Mean vessel, scaffold, and lumen diameters were 3.87 ± 0.51, 2.97 ± 0.49, and 2.68 ± 0.50 mm, respectively. Neither in-stent re-stenosis nor ST was detected. During follow-up, none of our patients died, suffered from stroke or needed target lesion revascularization. Clinical and angiographic 6-month follow-up (including OCT analyses) of BVS in CTO revascularization suggests their effectiveness and safety, even in very complex chronic occluded lesions. Nevertheless, more evidence is needed.

show abstract

Uso de aterectomía coronaria con LASER Excimer como terapia coadyuvante en intervencionismo coronario percutáneo

Cited by 8 publications

References 6 publications

Management of in-stent restenosis of the left main coronary artery with laser atherectomy guided by intracoronary optical coherence tomography

Management of in-stent restenosis of the left main coronary artery with laser atherectomy guided by intracoronary optical coherence tomography

Study on the mechanism of thrombus ablation in vitro by burst‐mode femtosecond laser

Bioresorbable vascular scaffolds in coronary chronic total occlusions revascularization: safety assessment related to struts coverage and apposition in 6-month OCT follow-up

Contact Info

Product

Resources

About