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Pullback atherectomy with the Arrow-Fischell atherectomy device

J Webb1, R Carere, E Lau

  • 1Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.

Catheterization and Cardiovascular Diagnosis
|September 1, 1997
PubMed
Summary
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The Arrow-Fischell catheter safely removes coronary artery plaque before other procedures. While effective, it yields less tissue than directional atherectomy and has limitations.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Devices

Background:

  • Coronary artery disease necessitates plaque removal.
  • Atherectomy catheters aim to debulk and retrieve atheroma.
  • The Arrow-Fischell device is a pullback atherectomy catheter.

Purpose of the Study:

  • To evaluate the safety and efficacy of the Arrow-Fischell pullback atherectomy catheter.
  • To assess the feasibility of using this device before balloon angioplasty or stenting.

Main Methods:

  • Retrospective analysis of 41 patients undergoing pullback atherectomy.
  • The device was used to debulk and retrieve coronary atheroma prior to angioplasty or stenting.
  • Success rates, tissue retrieval, and complications were recorded.

Related Experiment Videos

Main Results:

  • The device successfully crossed target lesions in 93% of patients and obtained tissue in 88%.
  • All procedures were completed without major adverse events like myocardial infarction, emergency surgery, or death.
  • Complications included significant coronary artery spasm (8 patients), abrupt vessel closure (1 patient), and arterial perforation (2 patients).

Conclusions:

  • Pullback atherectomy with the Arrow-Fischell catheter is feasible and can be performed relatively safely.
  • The procedure is more technically demanding than balloon angioplasty.
  • Tissue retrieval is less than with directional atherectomy, indicating significant limitations for this device.