CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

rhACE2 Therapy Modifies Bleomycin-Induced Pulmonary Hypertension via Rescue of Vascular Remodeling Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy Effect of SGLT2-Inhibitors on Epicardial Adipose Tissue: A Meta-Analysis Intravascular Ultrasound Parameters Associated With Stent Thrombosis After Drug-Eluting Stent Deployment Raising the Evidentiary Bar for Guideline Recommendations for TAVR: JACC Review Topic of the Week The Future of Biomarker-Guided Therapy for Heart Failure After the Guiding Evidence-Based Therapy Using Biomarker Intensified Treatment in Heart Failure (GUIDE-IT) Study Quality of Life after Everolimus-Eluting Stents or Bypass Surgery for Treatment of Left Main Disease 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC) Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM) Histopathologic validation of the intravascular ultrasound diagnosis of calcified coronary artery nodules The impact of intravascular ultrasound guidance during drug eluting stent implantation on angiographic outcomes

Clinical Trial2018 Apr;19(3 Pt A):268-272.

JOURNAL:Cardiovasc Revasc Med. Article Link

Orbital atherectomy for the treatment of small (2.5mm) severely calcified coronary lesions: ORBIT II sub-analysis

Lee MS, Shlofmitz RA, Shlofmitz E et al. Keywords: Atherectomy; Calcification; Cardiovascular intervention; Coronary artery disease

ABSTRACT


OBJECTIVES - We assessed the safety and efficacy of orbital atherectomy to modify severely calcified coronary plaque prior to stent implantation in patients with small vessel (2.5mm) disease.


BACKGROUND - Severe coronary artery calcification increases the risk of adverse clinical events during percutaneous coronary intervention (PCI). Patients who undergo PCI of small vessels have worse clinical outcomes including higher rates of perforation and dissection. The outcomes of orbital atherectomy of small diameter vessels (2.5mm) are unknown.

METHODS - ORBIT II was a single-arm, multicenter trial which prospectively enrolled patients with severely calcified coronary lesions treated with orbital atherectomy prior to stenting in 49U.S. sites. The primary endpoint was the 3year rate of major adverse cardiac events, which was the composite of cardiac death, myocardial infarction, and target vessel revascularization.

RESULTS - Of the 443 patients, 55 (12.4%) had reference vessel diameters (RVD) of 2.5mm and 388 (87.6%) had RVD >2.5. The rates of severe angiographic complications were similar in both groups. The primary endpoint was similar in both groups (30.6% vs. 22.5%, p=0.22), as were the rates of cardiac death (9.8% vs. 6.3%, p=0.33) and myocardial infarction (12.8% vs. 10.9%, p=0.67). Target vessel revascularization was numerically higher in the small vessel group (16.8% vs. 9.3%, p=0.13).

CONCLUSIONS - Patients with small coronary vessel disease had comparable clinical outcomes compared to the larger diameter group following orbital atherectomy. Subsequent studies are required to establish the optimal revascularization approach for such patients with small coronary vessel disease burdened by heavily calcified lesions.

Copyright © 2017 Elsevier Inc. All rights reserved.