Open Access
Stent deployment in calcified lesions Can we overcome calcific restraint with high pressure balloon inflations
Manolis Vavuranakis,Christodoulos Stefanadis,N. Giatrakos,Kostas Toutouzas,Elena Triantayllidou,Constantina Aggeli,Publos Toutouzas +6 more
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TLDR
In this paper, Liss et al. showed that stent lumen area with high pressure balloon inflations in moderate-severe calcified CA lesions are at the expense of symmetry.Abstract:
Although significant coronary artery (CA) calcification is believed to affect stent deployment, the exact impact on stent deployment after high‐pressure balloon inflations is unknown. Intracoronary intravascular examination (ICUS) was performed in 27 moderate‐severe calcified CA lesions before and after stent implantation. In case of unsatisfactory results (in‐stent area < 90%, minimal in‐stent diameter/maximal in‐stent diameter < 0.8), further inflations up to 20 atm guided by ICUS were applied. Initially, stent expansion was adequate in 10 stents (37%) and symmetric in 19 (70%). After inflation at 20 atm, stents with adequate expansion increased to 16 (59%, P = 0.0036), but stents with symmetry decreased to 13 (48%, P = 0.0045). Stent expansion was inversely correlated to the arc of calcium (r = ‐0.8, P < 0.0001). There were five patients with clinical restenosis at 6 months (18%). Increases in stent lumen area with high‐pressure balloon inflations in moderate‐severe calcified CA lesions are at the expense of symmetry. This may affect clinical restenosis. Cathet Cardiovasc Intervent 2001;52:164–172. © 2001 Wiley‐Liss, Inc.read more
Citations
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Journal ArticleDOI
Coronary artery calcification: pathogenesis and prognostic implications.
Mahesh V. Madhavan,Madhusudhan Tarigopula,Gary S. Mintz,Akiko Maehara,Gregg W. Stone,Philippe Généreux,Philippe Généreux +6 more
TL;DR: Although drug-eluting stents and devices for plaque modification have modestly improved outcomes in calcified vessels, adverse event rates are still high.
Journal ArticleDOI
Intravascular Imaging of Coronary Calcification and Its Clinical Implications
TL;DR: This review focuses on more than 20 years of intravascular imaging studies of the relationship between calcium and coronary atherosclerosis and finds that stable coronary lesions are associated with more calcium than unstable lesions; and the amount of calcium may affect the success of percutaneous coronary intervention.
Journal ArticleDOI
In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography.
Xiao Wang,Mitsuaki Matsumura,Gary S. Mintz,Tetsumin Lee,Wenbin Zhang,Yang Cao,Akiko Fujino,Yongqing Lin,Eisuke Usui,Yoshihisa Kanaji,Tadashi Murai,Taishi Yonetsu,Tsunekazu Kakuta,Akiko Maehara +13 more
TL;DR: Angiographic detection of target lesion coronary calcium (compared to intravascular imaging) has not changed in the past 2 decades, and angiographically invisible calcium (only detectable by IVUS or OCT) did not appear to inhibit stent expansion.
Journal ArticleDOI
North American Expert Review of Rotational Atherectomy
Samin K. Sharma,Matthew I. Tomey,Paul S. Teirstein,Annapoorna Kini,Arthur Reitman,Arthur C. Lee,Philippe Généreux,Jeffrey W. Chambers,Cindy L. Grines,Stevan I. Himmelstein,Craig Thompson,Ian T. Meredith,Aparna Bhave,Jeffrey W. Moses +13 more
TL;DR: A group of experienced RA operators and device experts are assembled to summarize and critique key elements of contemporary RA technique, to identify areas of consensus and controversy, and to offer recommendations for optimal performance for the practicing interventional cardiologist.
Journal ArticleDOI
Impact of lesion calcification on clinical and angiographic outcome after sirolimus-eluting stent implantation in real-world patients
Ren Kawaguchi,Hideki Tsurugaya,Hiroshi Hoshizaki,Takuji Toyama,Shigeru Oshima,Koichi Taniguchi +5 more
TL;DR: Coronary lesions with calcification comprise a high-risk cohort and are associated with a higher TLR and binary restenosis rates in real-world patients treated with sirolimus-eluting stent (SES), and patients with calcified lesions and on HD areassociated with higher MACE rate.
References
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A Comparison of Balloon-Expandable-Stent Implantation with Balloon Angioplasty in Patients with Coronary Artery Disease
Patrick W. Serruys,P. de Jaegere,Ferdinand Kiemeneij,Carlos Macaya,Wolfgang Rutsch,Gr. Heyndrickx,H. Emanuelsson,Jean Marco,Victor Legrand,P. Materne +9 more
TL;DR: The clinical and angiographic outcomes were better in patients who received a stent than in those who received standard coronary angioplasty, however, this benefit was achieved at the cost of a significantly higher risk of vascular complications at the access site and a longer hospital stay.
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A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease
David L. Fischman,Martin B. Leon,Donald S. Baim,Richard A. Schatz,Michael P. Savage,Ian M. Penn,Katherine D. Detre,Lisa Veltri,Donald R. Ricci,Masakiyo Nobuyoshi,Michael W. Cleman,Richard R. Heuser,David Almond,Paul S. Teirstein,R. David Fish,Antonio Colombo,Jeffrey C. Brinker,Jeffrey Moses,Alex Shaknovich,John N. Hirshfeld,Stephen Bailey,Stephen E. Ellis,Randal Rake,Sheldon Goldberg +23 more
TL;DR: In selected patients, placement of an intracoronary stent, as compared with balloon angioplasty, results in an improved rate of procedural success, a lower rate of angiographically detected restenosis, a similar rate of clinical events after six months, and a less frequent need for revascularization of the original coronary lesion.
Journal ArticleDOI
Predictive Factors of Restenosis After Coronary Stent Placement
Adnan Kastrati,Albert Schömig,Shpend Elezi,Helmut Schühlen,Josef Dirschinger,Martin Hadamitzky,Anne Wehinger,Jörg Hausleiter,Hanna Walter,Franz-Josef Neumann +9 more
TL;DR: Multivariate analysis demonstrated that diabetes mellitus, placement of multiple stents and minimal lumen diameter (MLD) immediately after stenting were the strongest predictors of restenosis.
Journal ArticleDOI
Intravascular ultrasound assessment of lumen size and wall morphology in normal subjects and patients with coronary artery disease.
Steven E. Nissen,John C. Gurley,Cindy L. Grines,David C. Booth,Rick R. McClure,Martin R. Berk,Charles Fischer,Anthony N. DeMaria +7 more
TL;DR: These data establish that intravascular ultrasound is feasible and safe and yields luminal measurements that correlate generally with angiography, and differences between angiographic and ultrasonic measures of lumen size in eccentric vessels probably reflect the dissimilar perspectives of tomographic and silhouette imaging techniques.
Journal ArticleDOI
Intravascular ultrasound imaging : in vitro validation and pathologic correlation
Rick A. Nishimura,William D. Edwards,Carole A. Warnes,Guy S. Reeder,David R. Holmes,A. Jamil Tajik,Paul G. Yock,Paul G. Yock +7 more
TL;DR: Intravascular ultrasound imaging is a new method in which high resolution images of the arterial wall are obtained with use of a catheter placed within an artery, and an excellent correlation was obtained with those calculated from microscopic slides.