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Rotational atherectomy in atherosclerotic rabbit iliac arteries
D D Hansen1, D C Auth, R Vracko
1Division of Cardiology, Seattle Veterans Administration Hospital, WA 98108.
Insights
A new rotational atherectomy device effectively removed atheromatous material from diseased rabbit arteries, offering a potential advancement for angioplasty procedures.
Area of Science:
- Cardiovascular Science
- Medical Devices
- Interventional Cardiology
Background:
- Percutaneous transluminal coronary angioplasty (PTCA) has limitations in treating complex coronary artery disease.
- PTCA does not physically remove atheroma, leading to common restenosis.
- Novel devices are needed to improve the efficacy of endovascular interventions.
Purpose of the Study:
- To evaluate a new rotating, abrasive-tipped angioplasty device for atheroma removal.
- To assess the safety and efficacy of rotational atherectomy in an in vivo atherosclerotic model.
Main Methods:
- Atherosclerosis was induced in rabbit iliac vessels using a high-cholesterol diet and balloon injury.
- The rotational atherectomy device was used to treat 13 diseased rabbit iliac vessels.
- In vitro analysis characterized particle size generated by the device.
Main Results:
- Rotational atherectomy significantly reduced arterial stenosis from 81% to 38% (p < 0.001).
- Histology confirmed the removal of diseased intimal portions.
- Ninety-eight percent of generated particles were under 10 microns, suggesting minimal embolic potential.
Conclusions:
- The rotational atherectomy device successfully removed atheromatous material in a rabbit model.
- This device shows potential to complement existing angioplasty techniques.
- It may expand the application of catheter-based interventions for cardiovascular disease.
Abstract:
PTCA is not technically possible in many patients with symptoms of coronary artery disease. In addition, atheroma is not physically removed by PTCA, and restenosis of the treated vessel is common. We have tested a new, rotating, abrasive-tipped angioplasty device in vivo in 13 atherosclerotic rabbit iliac vessels. Atherosclerosis was generated in rabbit iliac vessels by a 2% cholesterol diet combined with balloon endothelial injury for 10 weeks. The diseased vessels were then treated with the rotational atherectomy device. Before treatment, contrast angiograms demonstrated that initial percent diameter stenosis was 81% +/- 9%. After atherectomy, there was significant improvement, with residual 38% +/- 22% narrowing (p less than 0.001). One perforation resulted from distal guidewire manipulation, and one vessel was occluded by the device. Histologic examination demonstrated loss of portions of the diseased intima in all cases. Particles were produced for analysis in vitro by operating the atherectomy device in atherosclerotic rabbit aortas perfused with saline solution. Ninety-eight percent of the particles produced by the device were less than 10 micron in diameter. We conclude that this new rotational device can remove atheromatous material from diseased arteries in rabbits. Such a device may complement other angioplasty techniques and lead to wider application of catheter-based therapeutic interventions.