In vitro experimental models of branch orifices jailed by various stents were created to estimate the safety and the efficacy of rotational atherectomy when rotational burrs were advanced through the struts of stents. The scaffolding structures of the stents were destroyed due to loss and deflection of the struts, and the size of ablated stent-particles differed: the maximal size was 1.7 mm in slotted stents, and 17.6 mm in coiled stents. Thus, there is a definite potential for ablating stents when rotational atherectomy of restenotic lesions of side-branch orifices jailed by stents is performed.
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http://dx.doi.org/10.1253/jcj.63.537 | DOI Listing |
JACC Case Rep
January 2025
Cardiovascular Division, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
A 73-year-old man presented with acute coronary syndrome secondary to stent failure. Intravascular imaging identified a recurrent protruding calcific nodule as the mechanism, which was effectively treated with low-speed rotablation, resulting in ablation of the nodule allowing the application of a drug-coated balloon.
View Article and Find Full Text PDFBackground: Training in complex high-risk indicated percutaneous coronary intervention (CHIP-PCI) has frequently been reserved for established operators (consultants/attending) with trainees (fellows-in-training or FIT) being often discouraged from carrying out such procedures as a primary operator due to their high-risk nature. Whether the outcomes of these cases differ if the primary operator is a supervised FIT compared with a consultant is unknown.
Methods: Using multicentre PCI data from three cardiac centres in South Wales, UK (2018-2022), we identified 2295 CHIP-PCI cases with a UK-BCIS CHIP Score of 3 or more.
Med Phys
January 2025
School of Computer Science and Engineering, Beihang University, Beijing, China.
Background: Computed tomography angiography (CTA) is used to screen for coronary artery calcification. As the coronary artery has complicated structure and tiny lumen, manual screening is a time-consuming task. Recently, many deep learning methods have been proposed for the segmentation (SEG) of coronary artery and calcification, however, they often neglect leveraging related anatomical prior knowledge, resulting in low accuracy and instability.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
January 2025
Department of Cardiology, Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
We report the case of a 73-year-old male with a history of recurrent coronary interventions who presented with progressive angina and was diagnosed with a chronic total occlusion (CTO) of a heavily calcified and tortuous right coronary artery (RCA). Standard antegrade and retrograde techniques were attempted but failed due to the complexity of the lesion. A novel "Drag-Drill" technique was employed, utilizing a retrogradely externalized RG3 guidewire as a rotational atherectomy wire, enabling successful rotational atherectomy and percutaneous coronary intervention (PCI).
View Article and Find Full Text PDFBackground: The Centers for Medicare and Medicaid Services (CMS) New Technology Add-on Payment (NTAP) program supports adoption of new, costly medical technologies demonstrating substantial clinical improvement. In 2021, CMS waived the "substantial clinical improvement" criterion for devices designated under the FDA Breakthrough Devices Program (BDP). This study characterized risk-standardized payments associated with hospitalizations in which Medicare beneficiaries received calcium modification during PCI for acute myocardial infarction (AMI) following the adoption of the Shockwave C Coronary Intravascular Lithotripsy (IVL) Catheter (Shockwave Medical) with BDP designation.
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