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Coronary Flow Reserve Assessment of Orbital Atherectomy: An Observational Pilot Study
Cardiovascular Research and New Devices, Mercy Gilbert Medical Center, Gilbert, USA
Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, USA
Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, USA
Technology Solutions Group, Moreland Hills, USA
International Society for Cardiovascular Translational Research, Phoenix, USA
Premier Cardiovascular Center, Dignity Health Chandler Hospital, Chandler, USA
Chicago Medical School, North Chicago, USA
Department of Cardiology, St. Francis Hospital, Heart Center, Roslyn, USA
Metropolitan Heart and Vascular Institute, Mercy Hospital, Minneapolis, USA
- 1 Cardiovascular Research and New Devices, Mercy Gilbert Medical Center, Gilbert, USA
- 2 Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, USA
- 3 Scientific Affairs, Cardiovascular Systems, Inc., St. Paul, USA
- 4 Technology Solutions Group, Moreland Hills, USA
- 5 International Society for Cardiovascular Translational Research, Phoenix, USA
- 6 Premier Cardiovascular Center, Dignity Health Chandler Hospital, Chandler, USA
- 7 Chicago Medical School, North Chicago, USA
- 8 Department of Cardiology, St. Francis Hospital, Heart Center, Roslyn, USA
- 9 Metropolitan Heart and Vascular Institute, Mercy Hospital, Minneapolis, USA
Journal of Biomedical Science and Engineering·Volume 12 (2019)·Pages 269–275·Published 22 April 2019·DOI10.4236/jbise.2019.124019
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Abstract
The aim of this prospective observational pilot study was to observe the impact of orbital atherectomy (OA) on the coronary microcirculation via coronary flow reserve (CFR) measurements. Fifteen subjects who had successful OA and stent placement with no procedural complication were enrolled at 3 hospitals in the U.S. Baseline and hyperemic velocities were 16 ± 5.2 and 36 ± 14 cm/sec, respectively. The average CFR post-procedure was within the normal range at 2.23 ± 0.33. The observation of normal CFR following OA may be attributed to the orbital action of the device that allows for continuous flow during treatment, minimizing a bolus embolization effect which can impact microvascular function.
KeywordsPercutaneous Coronary InterventionMicrovascular FunctionOrbital AtherectomyCalcified LesionsCoronary Flow Reserve
- Bass, T.A. (2017) Percutaneous Coronary Interventions for Chronic Total Occlusions: As the Technology Expands, Our Responsibilities Increase. Circulation, 135, 1385-1387. https://doi.org/10.1161/CIRCULATIONAHA.116.022151
- Généreux, P., Madhavan, M.V., Mintz, G.S., Maehara, A., Palmerini, T., Lasalle, L., et al. (2014) Ischemic Outcomes after Coronary Intervention of Calcified Vessels in Acute Coronary Syndromes: Pooled Analysis from the Horizons-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) and Acuity (Acute Catheterization and Urgent Intervention Triage Strategy) Trials. Journal of the American College of Cardiology, 63, 1845-1854. https://doi.org/10.1016/j.jacc.2014.01.034
- Benezet, J., Diaz de la Llera, L.S., Cubero, J.M., Villa, M., Fernandez-Quero, M. and Sanchez-Gonzalez, A. (2011) Drug-Eluting Stents Following Rotational Atherectomy for Heavily Calcified Coronary Lesions: Long-Term Clinical Outcomes. Journal of Invasive Cardiology, 23, 28-32.
- Schlüter, M., Cosgrave, J., Tübler, T., Melzi, G., Colombo, A. and Schofer, J. (2007) Rotational Atherectomy to Enable Sorolimus-Eluting Stent Implantation in Calcified, Nondilatable De Novo Coronary Artery Lesions. Vascular Disease Management, 4, 63-69.
- Moussa, I., Ellis, S.G., Jones, M., Kereiakes, D.J., McMartin, D., Rutherford, B., et al. (2005) Impact of Coronary Culprit Lesion Calcium in Patients Undergoing Paclitaxel-Eluting Stent Implantation (A Taxus-IV Sub Study). American Journal of Cardiology, 96, 1242-1247. https://doi.org/10.1016/j.amjcard.2005.06.064
- Shlofmitz, E., Martinsen, B.J., Lee, M., Rao, S.V., Généreux, P., Higgins, J., et al. (2017) Orbital Atherectomy for the Treatment of Severely Calcified Coronary Lesions: Evidence, Technique, and Best Practices. Expert Review of Medical Devices, 14, 867-879. https://doi.org/10.1080/17434440.2017.1384695
- Chambers, J.W., Behrens, A.N. and Martinsen, B.J. (2016) Atherectomy Devices for the Treatment of Calcified Coronary Lesions. Interventional Cardiology Clinics, 5, 143-151. https://doi.org/10.1016/j.iccl.2015.12.003
- Chambers, J.W. and Martinsen, B.J. (2016) Orbital Atherectomy in the Coronary Arteries. In: Shammas, N.W., Ed., Textbook of Atherectomy, HMP Communications, 217-240.
- Lee, M.S. and Shah, N. (2016) The Impact and Pathophysiologic Consequences of Coronary Artery Calcium Deposition in Percutaneous Coronary Interventions. Journal of Invasive Cardiology, 28, 160-167.