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Coronary orbital atherectomy using a five-French guiding catheter

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Abstract

Recently, the efficacy was demonstrated of the Diamondback 360® Coronary Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc., St. Paul, MN, USA) for treating calcified coronary lesions in percutaneous coronary intervention (PCI). The safety and feasibility of OAS application through a 5-Fr guiding catheter (GC) which is less invasive and reduces access site complications were validated. This sequential, retrospective, observational study was conducted in a single center from September 2018 to May 2020. The primary endpoint was a successful PCI with the OAS. Secondary endpoints were major adverse complications related to PCI with the OAS, including coronary dissection, perforation, side branch loss, need for an unexpected cardiac assist device, access site complications, and major adverse cardiac and cerebrovascular events. 33 PCIs in 30 patients (mean age 72 ± 11 years; male, 83.3%) were surveyed. All PCIs were successfully completed with OAS application through a 5-Fr GC. Coronary perforation after the OAS procedure occurred in one case (3.0%). Severe coronary dissection occurred in three cases (9.1%), and procedural myocardial infarction in two cases (6.1%). Regarding PCIs performed with the 5-Fr GC, the OAS is a safe and feasible strategy for calcified plaque modification.

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References

  1. Bønaa KH, Mannsverk J, Wiseth R, Aaberge L, Myreng Y, Nygård O, et al. Drug-eluting or bare-metal stents for coronary artery disease. N Engl J Med. 2016;375:1242–52.

    Article  Google Scholar 

  2. Poerner TC, Haase KK, Duda S. Impact of stent design on clinical outcome after coronary stent implantation [Internet]. Minim. Invasive Ther. Allied Technol. Minim Invasive Ther Allied Technol; 2002 [cited 2020 Aug 17]. p. 203–9. https://pubmed.ncbi.nlm.nih.gov/16754071/

  3. Jolly SS, Yusuf S, Cairns J, Niemelä K, Xavier D, Widimsky P, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): A randomised, parallel group, multicentre trial. Lancet [Internet]. Elsevier Ltd; 2011;377:1409–20. /https://doi.org/10.1016/S0140-6736(11)60404-2

  4. Baber U, Kini AS, Sharma SK. Stenting of complex lesions: An overview. Nat. Rev. Cardiol. 2010.

  5. Kawamura Y, Nagaoka M, Ito D, Iseki H, Ikari Y. A case of percutaneous coronary intervention procedure successfully bailed out from multiple complications in hemodialysis patient. Cardiovasc Interv Ther. 2013;

  6. Kassimis G, Raina T, Kontogiannis N, Patri G, Abramik J, Zaphiriou A, et al. How Should We Treat Heavily Calcified Coronary Artery Disease in Contemporary Practice? From Atherectomy to Intravascular Lithotripsy. Cardiovasc Revascularization Med [Internet]. Elsevier Inc.; 2019;20:1172–83. https://doi.org/10.1016/j.carrev.2019.01.010

  7. R.S. C-H, U. B, M. A, A. R, S. R, C. H, et al. Prevalence, correlates, and impact of coronary calcification on adverse events following PCI with newer-generation DES: Findings from a large multiethnic registry. Catheter Cardiovasc Interv. 2018;

  8. Madhavan M V., Tarigopula M, Mintz GS, Maehara A, Stone GW, Généreux P. Coronary artery calcification: Pathogenesis and prognostic implications. J. Am. Coll. Cardiol. 2014.

  9. Tomey MI, Kini AS, Sharma SK. Current status of rotational atherectomy. JACC Cardiovasc. Interv. 2014.

  10. Chambers JW, Feldman RL, Himmelstein SI, Bhatheja R, Villa AE, Strickman NE, et al. Pivotal trial to evaluate the safety and efficacy of the orbital atherectomy system in treating de Novo, severely calcified coronary lesions (ORBIT II). JACC Cardiovasc Interv. 2014;

  11. Parikh K, Chandra P, Choksi N, Khanna P, Chambers J. Safety and feasibility of orbital atherectomy for the treatment of calcified coronary lesions: The ORBIT i Trial. Catheter Cardiovasc Interv. 2013;

  12. Uhlemann M, Möbius-Winkler S, Mende M, Eitel I, Fuernau G, Sandri M, et al. The Leipzig prospective vascular ultrasound registry in radial artery catheterization: Impact of sheath size on vascular complications. JACC Cardiovasc Interv. 2012;

  13. Yoshimachi F, Kiemeneij F, Masutani M, Matsukage T, Takahashi A, Ikari Y. Safety and feasibility of the new 5 Fr Glidesheath Slender. Cardiovasc Interv Ther. 2016;

  14. Takeshita S, Asano H, Hata T, Hibi K, Ikari Y, Kan Y, et al. Comparison of frequency of radial artery occlusion after 4fr versus 6fr transradial coronary intervention (from the novel angioplasty using coronary accessor trial). Am J Cardiol. 2014;

  15. Yasumura K, Benhuri B, Vengrenyuk Y, Petrov A, Barman N, Sweeny J, et al. Procedural and 1-year clinical outcomes of orbital atherectomy for treatment of coronary in-stent restenosis: a single-center, retrospective study. Catheter Cardiovasc Interv. 2021;97:E280–7.

    Article  Google Scholar 

  16. Neupane S, Basir M, Tan C, Sultan A, Tabaku M, Alqarqaz M, et al. Feasibility and safety of orbital atherectomy for the treatment of in-stent restenosis secondary to stent under-expansion. Catheter Cardiovasc Interv. 2021;97:2–7.

    Article  Google Scholar 

  17. Meraj PM, Shlofmitz E, Kaplan B, Jauhar R, Doshi R. Clinical outcomes of atherectomy prior to percutaneous coronary intervention: a comparison of outcomes following rotational versus orbital atherectomy (COAP-PCI study). J Interv Cardiol. 2018;31:478–85.

    Article  Google Scholar 

  18. Gwon HC, Doh JH, Choi JH, Lee SH, Hong KP, Park JE, et al. A 5Fr catheter approach reduces patient discomfort during transradial coronary intervention compared with a 6Fr approach: A prospective randomized study. J Interv Cardiol. 2006;

  19. Lasevitch R, Melchior R, Gomes V, Berg C, Roman M, Alcalde R, et al. Early discharge using five French guiding catheter for transfemural coronary stenting: A feasibility and safety study (EDU 5Fr study). Am J Cardiol. 2005;

  20. Aminian A, Saito S, Takahashi A, Bernat I, Jobe RL, Kajiya T, et al. Comparison of a new slender 6 Fr sheath with a standard 5 Fr sheath for transradial coronary angiography and intervention: RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT), a randomised multicentre trial. EuroIntervention. 2017;13:e549–56.

    Article  Google Scholar 

  21. Sotomi Y, Cavalcante R, Shlofmitz RA, Suwannasom P, Tateishi H, Tenekecioglu E, et al. Quantification by optical coherence tomography imaging of the ablation volume obtained with the Orbital Atherectomy System in calcified coronary lesions. EuroIntervention. 2016;12:1126–34.

    Article  Google Scholar 

  22. Yamamoto MH, Maehara A, Kim SS, Koyama K, Kim SY, Ishida M, et al. Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography. Catheter Cardiovasc Interv. 2019;93:1211–8.

    Article  Google Scholar 

  23. Fujimoto Y, Tonoike N, Kobayashi Y. Successful delivery of polytetrafluoroethylene-covered stent using rapid exchange guide extension catheter. Cardiovasc Interv Ther Springer Japan. 2017;32:142–5.

    Article  CAS  Google Scholar 

  24. Desai R, Mirza O, Martinsen BJ, Kumar G. Plaque modification of severely calcified coronary lesions via orbital atherectomy: Single-center observations from a complex Veterans Affairs cohort. Heal Sci Reports. 2018;1:e99.

  25. Sakakura K, Taniguchi Y, Matsumoto M, Wada H, Momomura S, Fujita H. How Should We Perform Rotational Atherectomy to an Angulated Calcified Lesion? 2016;376–9.

  26. Abdel-Wahab M, Toelg R, Byrne RA, Geist V, El-Mawardy M, Allali A, et al. High-speed rotational atherectomy versus modified balloons prior to drug-eluting stent implantation in severely calcified coronary lesions: The randomized prepare-CALC trial. Circ Cardiovasc Interv. 2018;11:1–12.

    Google Scholar 

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Correspondence to Yota Kawamura.

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Kawamura, Y., Yoshimachi, F., Murotani, N. et al. Coronary orbital atherectomy using a five-French guiding catheter. Cardiovasc Interv and Ther 37, 498–505 (2022). https://doi.org/10.1007/s12928-021-00813-3

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  • DOI: https://doi.org/10.1007/s12928-021-00813-3

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