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Intravascular ultrasound enhances the safety of rotational atherectomy In vivo comparison of lipid-rich plaque on near-infrared spectroscopy with histopathological analysis of coronary atherectomy specimens One-Year Outcomes of Orbital Atherectomy of Long, Diffusely Calcified Coronary Artery Lesions Clinical Characteristics and Long-Term Outcomes of Rotational Atherectomy-J2T Multicenter Registry North American Expert Review of Rotational Atherectomy Coronary Calcification and Long-Term Outcomes According to Drug-Eluting Stent Generation Orbital atherectomy for the treatment of small (2.5mm) severely calcified coronary lesions: ORBIT II sub-analysis Procedural Success and Outcomes With Increasing Use of Enabling Strategies for Chronic Total Occlusion Intervention Trends in Usage and Clinical Outcomes of Coronary Atherectomy: A Report From the National Cardiovascular Data Registry CathPCI Registry Pivotal trial to evaluate the safety and efficacy of the orbital atherectomy system in treating de novo, severely calcified coronary lesions (ORBIT II)
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Review Article2017 Sep 23 [Epub ahead of print]

JOURNAL：Cardiovasc Revasc Med. Article Link

Intravascular ultrasound enhances the safety of rotational atherectomy

Sakakura K, Yamamoto K, Taniguchi Y et al. Keywords: Intravascular ultrasound; Percutaneous coronary intervention; Rotational atherectomy

ABSTRACT

Intravascular ultrasound (IVUS) is mainly used in PCI to treat complex lesions, such as left main bifurcation, chronic total occlusion and calcified lesions. Although IVUS yields useful information such as the presence of napkin-ring calcification, the role of IVUS in rotational atherectomy (RA) is not fully appreciated. Recently, since the deliverability and crossability of IVUS catheters have improved, IVUS should be attempted before RA. Even if the IVUS catheter cannot cross the lesion, IVUS provides information just proximal to the target lesion, which would be useful in the selection of the appropriate guidewire and burr size. IVUS can be repeated following RA, which may influence the decision to continue RA with larger burrs. Circumferential calcification is a good indication for RA, since RA can create a calcium crack that facilitates balloon dilatation. However, if the distribution of calcification is not circumferential, the indication for RA can more safely be determined based on IVUS images than angiographic information alone. Because RA burrs usually follow the route taken by the IVUS catheter, the positional relationship between the IVUS imaging core and calcification would be similar to that between the RA burrs and calcification. The relationship between the RA burrs and distribution of calcification is discussed in this review.


Copyright © 2017 Elsevier Inc. All rights reserved.

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