Related Experiment Video

Updated: Aug 4, 2025

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

11.8K

Percutaneous Coronary Intervention and Discretionary Atherectomy in Patients with Aortic Stenosis: 2016-2019 National

Karthik Vedantam1, Christian A Torres1, Brad J Martinsen2

  • 1Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, FL, USA.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|March 30, 2023
PubMed

Insights

Percutaneous coronary intervention (PCI) with atherectomy is increasingly used in patients with aortic stenosis (AS) and coronary artery disease (CAD). Intravascular ultrasound (IVUS) guided PCI with or without atherectomy appears safe and feasible in this complex patient group.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Aortic stenosis (AS) frequently coexists with calcified coronary artery disease (CAD).
  • Atherectomy is often necessary to facilitate percutaneous coronary intervention (PCI) in AS patients.
  • Limited data exists on PCI outcomes with or without atherectomy in AS patients.

Purpose of the Study:

  • To evaluate trends, safety, outcomes, costs, and predictors of major adverse cardiovascular events (MACE) for PCI with or without atherectomy in patients with AS.
  • To assess the feasibility and safety of intravascular ultrasound (IVUS) guided PCI in this population.

Main Methods:

  • Analysis of the National Inpatient Sample (NIS) database (2016-2019).
  • Identification of patients with AS undergoing PCI with or without atherectomy (Orbital Atherectomy [OA], non-OA) using ICD-10 codes.
  • Assessment of temporal trends, safety, outcomes, costs, and MACE correlates using discharge-weighted data.

Main Results:

  • Over 45,000 AS patients underwent PCI; 88.6% received PCI-only, 2.3% OA, and 9.1% non-OA atherectomy.
  • Significant increases observed in PCI, atherectomy use, and IVUS utilization from 2016-2019.
  • Atherectomy cohorts had higher median admission costs compared to PCI-only.
  • IVUS-guided PCI with or without atherectomy was associated with decreased odds of MACE.

Conclusions:

  • PCI with or without atherectomy in AS patients has significantly increased between 2016 and 2019.
  • Overall complication rates were comparable across PCI and atherectomy groups, indicating good safety.
  • IVUS-guided PCI, with or without atherectomy, is a feasible and safe strategy for AS patients with complex comorbidities.
Abstract

Keywords:
Aortic stenosisAtherectomyOutcomesPercutaneous coronary interventionTrends

More Related Videos

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia07:25

Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia

Published on: September 22, 2020

3.5K
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

25.6K

Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
15
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
18
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
16
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
12
Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
30
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
17