DIAMondback Atherectomy With OCT Visualization for Calcified PAD Lesions (DIAMOCT-PAD Study)

Area of Science:

• Vascular Medicine
• Interventional Cardiology
• Medical Imaging

Background:

• Orbital atherectomy system (OAS) debulking of calcified atherosclerotic plaque may improve vessel compliance and angioplasty outcomes.
• Peripheral arterial disease (PAD) with calcified lesions presents challenges for revascularization.

Purpose of the Study:

• To describe the immediate and long-term vascular effects of OAS in patients with PAD and moderate to severely calcified lesions.
• To evaluate changes in luminal volume and plaque composition post-OAS treatment.

Main Methods:

• Seven patients with significant superficial femoral artery (SFA) disease underwent OAS treatment.
• Intravascular optical coherence tomography (IV-OCT) was used for baseline, post-treatment, and 6-month follow-up imaging.
• A convolutional neural network algorithm aided in automated plaque classification from IV-OCT images.

Main Results:

• The majority of debulked tissue was fibrous.
• Luminal volume increased by an average of 6% at 6-month follow-up (P<.01).
• Individual patient responses varied, with 4 of 7 showing increased luminal volume.

Conclusions:

• OAS treatment demonstrated a positive effect on luminal volume in patients with severe PAD and calcified lesions.
• This is the first study to report on the vascular effects of OAS in medial calcified lesions using IV-OCT at immediate and follow-up time points.