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Excimer laser coronary atherectomy for uncrossable coronary lesions. A multicenter registry

Soledad Ojeda1, Lorenzo Azzalini2,3, Javier Suárez de Lezo1

  • 1Division of Interventional Cardiology, Reina Sofia Hospital, University of Córdoba, Maimonides Institute for Research in Biomedicine of Córdoba (IMIBIC), Córdoba, Spain.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|November 24, 2020
PubMed

Insights

Excimer laser coronary atherectomy (ELCA) is safe and effective for treating uncrossable coronary lesions. Severe calcification independently predicts ELCA failure, highlighting a key challenge in percutaneous coronary intervention.

Area of Science:

  • Cardiovascular Interventions
  • Interventional Cardiology
  • Laser Atherectomy

Background:

  • Uncrossable coronary lesions pose significant challenges for standard percutaneous coronary intervention (PCI).
  • Excimer laser coronary atherectomy (ELCA) offers a potential solution for these complex lesions.

Purpose of the Study:

  • To evaluate the efficacy, safety, and long-term outcomes of ELCA in uncrossable coronary lesions.
  • To identify factors associated with ELCA failure.

Main Methods:

  • A multicenter registry of 126 patients with uncrossable lesions undergoing ELCA.
  • Assessment of ELCA success, technical success, and a composite endpoint of major adverse cardiac events (cardiac death, myocardial infarction, target-lesion revascularization) at follow-up.
  • Analysis of predictors for ELCA failure.

Main Results:

  • ELCA success was achieved in 81.8% of patients.
  • Technical and procedural success rates were 90.5% and 87.3%, respectively.
  • Severe calcification (OR: 3.73) was independently associated with ELCA failure. Low rates of major adverse cardiac events were observed at follow-up (median 424 days).

Conclusions:

  • ELCA is a safe and reasonably effective treatment option for uncrossable coronary lesions.
  • Severe lesion calcification is a significant predictor of ELCA failure.
  • The study demonstrates a relatively low rate of adverse events during follow-up.
Abstract

Keywords:
calcificationcoronary chronic total occlusionlaserpercutaneous coronary intervention

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