Adjunctive Procedures (Thrombectomy, Atherectomy, Special Balloons)
Acute and Mid-Term Results of Percutaneous Coronary Intervention for Severely Calcified Coronary Artery Lesions With Orbital Atherectomy System (OAS)
Jumpei Koike1, Yoshihiro Iwasaki1, Atsushi Funatsu1, Tomoko Kobayashi1, Shigeru Nakamura1
Kyoto Katsura Hospital, Japan1
Severely calcified lesions present many challenges to percutaneous coronary intervention (PCI). Recently, a newly developed at herectomy device, Diamondback coronary orbital atherectomy system (OAS) has been approved.
328 consecutive cases (417lesions) who underwent PCI with OAS in Kyoto Katsura Hospital from February 2018 to March 2021 were enrolled. We assessed the clinical outcomes after OASof severely calcified lesions; procedure success, angiographic complications,In-hospital MACE (Cardiac death, Myocardial Infarction (MI : SCAI definition of periprocedural MI (CK-MB >10×ULN without new Q waves or >5× ULNwith new Q waves), and Target Vessel / Lesion Revascularization (TVR/TLR)) and mid-term results.
Mean age was 76 years and 75% patients were male. Denovo lesions were 83% and in stent restenosis (ISR) was 8%. Optical FrequencyDomain Imaging (OFDI) was used as imaging device in 54% of all Cases. Weperformed OAS at low revolution speed in all cases and made an addition at highrevolution speed in 66% lesions. 9% lesions additionally needed rotationalatherectomy. 81% lesions were finally treated with drug coated balloon (DCB),and stents were implanted in 14% lesions. Procedural success rate was 98%. Incomplications, coronary perforation occurred in 1% lesion and persistent slowflow in 2%. There were 1 cardiac death (0.5%), 30 nonQ MI (9%) and no TLR as inhospital MACE. In post discharge MACE, all cause death rate was 6%, there were noMI and 40 TVR/TVF cases (12%). Follow up angiography was performed in 274lesions (69%) we eligible follow up at 8 months. Restenosis was observed in 9%(25/274) lesions.
OAS has been shown to have high procedure success rate and low restenosis rate. OASas a lesion preparation tool may offer a new treatment for the patients with severe calcified lesions.