| Orbital atherectomy for symptomatic lower extremity disease. | |
| | |
MedLine Citation:
|
PMID: 20839344 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Plaque-debulking technologies have been proposed as alternative treatment options for peripheral arterial disease. Orbital atherectomy (OA), using the DiamondBack360 device, has emerged as one promising modality. METHODS: We evaluated the safety and efficacy of OA in the first 200 lesions treated at our institution. Patient demographics, clinical characteristics, and lesion and procedural variables were collected and analyzed. The primary safety endpoint was the 30-day major adverse events (MAE), including death, myocardial infarction, stroke, unplanned amputation, or target lesion revascularization. Other safety endpoints included access-site complications, occurrence of dissections, perforations, distal embolization, spasm, and hemolysis. The efficacy endpoints were procedural success, need for adjunctive therapy, and improvement in ankle-brachial index. Multivariate analysis was performed to find independent predictors of the safety endpoints. RESULTS: One hundred seventeen (58.5%) lesions were femoral, 31 (15.5%) were popliteal, and 52 (26.0%) were tibial. The procedural success (residual stenosis ≤30%) was comparable between the femoral and tibial lesions (86.3% vs. 92.5%, P = 0.18), but significantly lower for the popliteal lesions when compared with femoral and tibial (64.7% vs. 86.3%, P = 0.058, and 64.7% vs. 92.5%, P = 0.007 respectively). MAE at 30-days occurred in 3 (2.2%) procedures, and major access-site complications also occurred in 3 (2.2%). There were 31 (15.5%) dissections; independent predictors were diabetes mellitus (OR: 7.3, P = 0.008), crown-to-RVD ratio <0.6 (OR: 11.6, P = 0.005), and atherectomy time >360 sec (OR: 11.8, P = 0.001). There were 2 (1.0%) distal embolizations, 6 (3.0%) arterial spasms, and no perforations. Laboratory evidence of hemolysis was noted in 33.8% of cases. CONCLUSION: Orbital atherectomy allows for a significant procedural success, limited need for stenting, and favorable safety profile. |
| | |
Authors:
|
Ravikiran Korabathina; Kanika P Mody; Jennie Yu; Seol Young Han; Ruchika Patel; Cezar S Staniloae |
Related Documents
:
|
14743134 - Hemodynamic outcome of endovascular therapy for transatlantic intersociety consensus ty... 1835704 - Chronic lower limb ischaemia. a prospective randomised controlled study comparing the 1... 18670374 - Invasive treatment for renovascular disease. a twenty year experience from a population... 22954974 - Pituitary dysfunction in survivors of spontaneous subarachnoid hemorrhage of anterior c... 22581634 - Endoscopic dacryocystorhinostomy with double posteriorly based nasal and lacrimal flaps... 20806774 - Efficacy of outpatient bilateral simultaneous hallux valgus surgery. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions Volume: 76 ISSN: 1522-726X ISO Abbreviation: Catheter Cardiovasc Interv Publication Date: 2010 Sep |
Date Detail:
|
Created Date: 2010-09-14 Completed Date: 2011-01-14 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 100884139 Medline TA: Catheter Cardiovasc Interv Country: United States |
Other Details:
|
Languages: eng Pagination: 326-32 Citation Subset: IM |
Affiliation:
|
Saint Vincent's Hospital Manhattan, New York Medical College, New York, NY, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Aged, 80 and over Amputation Ankle Brachial Index Atherectomy / adverse effects, instrumentation, methods*, mortality Chi-Square Distribution Embolism / etiology Female Hemolysis Humans Lower Extremity / blood supply* Male Middle Aged Myocardial Infarction / etiology New York City Odds Ratio Peripheral Arterial Disease / diagnosis, mortality, therapy* Registries Risk Assessment Risk Factors Spasm / etiology Stroke / etiology Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The New Zealand black mouse as a model for the development and progression of chronic lymphocytic le...
Next Document: Angioplasty of ulnar or radial arteries to treat critical hand ischemia: use of 3- and 4-French syst...