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"Single-Operator" Technique for Advancing the Orbital Atherectomy Device.

Michael S Lee1, Heajung Nguyen, Daniel Philipson

  • 1UCLA Medical Center, 100 Medical Plaza Suite 630, Los Angeles, CA 90095 USA. mslee@mednet.ucla.edu.

The Journal of Invasive Cardiology
|March 4, 2017
PubMed
Summary
This summary is machine-generated.

The single-operator orbital atherectomy (OA) technique is feasible and safe for treating complex coronary artery calcification (CAC). This method allows operators to advance the OA device while maintaining wire position, eliminating the need for an assistant.

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Area of Science:

  • Interventional Cardiology
  • Cardiovascular Devices
  • Percutaneous Coronary Intervention

Background:

  • Severe coronary artery calcification (CAC) complicates percutaneous coronary intervention (PCI), leading to poorer outcomes.
  • Orbital atherectomy (OA) effectively treats CAC for optimal stent expansion.
  • Barriers to OA use include operator inexperience, lack of skilled assistants, and wire migration concerns.

Purpose of the Study:

  • To assess the feasibility and safety of a "single-operator" technique for orbital atherectomy (OA).
  • To determine if an operator can autonomously advance the OA device while maintaining wire position.

Main Methods:

  • Prospective study of 50 consecutive patients undergoing OA from February 2014 to September 2016.
  • Primary endpoint: successful OA device delivery with maintained distal wire position and procedural success.

Main Results:

  • The primary endpoint was achieved in 100% of patients.
  • 30-day major adverse cardiac and cerebrovascular event rate was 6.0% (2% death, 4% myocardial infarction).
  • No target-vessel revascularization, stroke, or stent thrombosis occurred; perforation (2%) and slow-flow (4%) were managed successfully.

Conclusions:

  • The single-operator technique for OA is feasible and safe.
  • This technique allows for maintaining wire position during OA device advancement.
  • It negates the requirement for a skilled assistant during OA device advancement.