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Sökning: onr:"swepub:oai:lup.lub.lu.se:efe9cc4b-6d22-49d1-9612-b692330d774f" > Optical Coherence T...

Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions : First Description

Ali, Ziad A. (författare)
Columbia University
Brinton, Todd J. (författare)
Stanford University Medical Center
Hill, Jonathan M. (författare)
King's College Hospital
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Maehara, Akiko (författare)
Columbia University
Matsumura, Mitsuaki (författare)
Columbia University
Karimi Galougahi, Keyvan (författare)
Columbia University
Illindala, Uday (författare)
Shockwave Medical Inc.
Götberg, Matthias (författare)
Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
Whitbourn, Robert (författare)
St. Vincent's Hospital, Melbourne
Van Mieghem, Nicolas (författare)
Amsterdam UMC - Vrije Universiteit Amsterdam
Meredith, Ian T. (författare)
Monash Medical Centre
Di Mario, Carlo (författare)
Royal Brompton Hospital
Fajadet, Jean (författare)
Clinique Pasteur, Toulouse
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 (creator_code:org_t)
Elsevier BV, 2017
2017
Engelska 10 s.
Ingår i: JACC: Cardiovascular Imaging. - : Elsevier BV. - 1936-878X. ; 10:8, s. 897-906
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Objectives This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT). Background The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e., lithoplasty) for vessel preparation before stent implantation. Methods We analyzed OCT findings in 31 patients in whom lithoplasty was used to treat severely calcified stenotic coronary lesions. Results After lithoplasty, intraplaque calcium fracture was identified in 43% of lesions, with circumferential multiple fractures noted in >25%. The frequency of calcium fractures per lesion increased in the most severely calcified plaques (highest tertile vs. lowest tertile; p = 0.009), with a trend toward greater incidence of calcium fracture (77.8% vs. 22.2%; p = 0.057). Post-lithoplasty, mean acute area gain was 2.1 mm2, which further increased with stent implantation, achieving a minimal stent area of 5.94 ± 1.98 mm2 and mean stent expansion of 112.0 ± 37.2%. Deep dissections, as part of the angioplasty effect, occurred in 13% of cases and were successfully treated with stent implantation without incidence of acute closure, slow flow/no reflow, or perforation. Conclusions High-resolution imaging by OCT delineated calcium modification with fracture as a major mechanism of action of lithoplasty in vivo and demonstrated efficacy in the achievement of significant acute area gain and favorable stent expansion.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

calcification
coronary artery disease
intravascular imaging
optical coherence tomography

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