Author + information
- Judit Karacsonyi1,
- Jose Roberto Martinez-Parachini2,
- Aya Alame3,
- Barbara Anna Danek4,
- Aris Karatasakis5,
- Phuong-Khanh Nguyen-Trong6,
- Rahel Iwentu7,
- Erica Resendes2,
- Pratik Kalsaria2,
- Michele Roesle7,
- Imre Ungi8,
- Subhash Banerjee9,
- Emmanouil Brilakis10 and
- Bavana Rangan9
- 1UT Southwestern Medical Center, Dallas, VA North Texas Healthcare System, Dallas, Texas, United States
- 2UT Southwestern Medical Center, Dallas, Texas, United States
- 3Dallas VA Medical Center
- 4Dallas VA Medical Center/UT Southwestern, Dallas, Texas, United States
- 5Dallas VAMC and UT Southwestern, Dallas, Texas, United States
- 6UT Southwestern, Dallas, Texas, United States
- 7Dallas VA Medical Center, Dallas, Texas, United States
- 8University of Szeged, Szeged, Hungary
- 9UT Southwestern Medical Center/ VA North Texas Health Care System, Dallas, Texas, United States
- 10Minneapolis Heart Institute, UT Southwestern Medical Center/VA North Texas Health Care System, Dallas, Texas, United States
We sought to examine contemporary use and outcomes of excimer laser coronary atherectomy (ELCA - Spectranetics) in percutaneous coronary intervention (PCI).
We examined the baseline clinical and angiographic characteristics and procedural outcomes of 77 consecutive PCIs in which ELCA was performed between 2008 and 2016 at a tertiary US center.
Mean age was 66.8 ± 9 years and 95% of the patients were men, with high prevalence of diabetes mellitus (64%), congestive heart failure (45%), prior coronary artery bypass graft surgery (47%) and prior myocardial infarction (60%). The most common indication for ELCA was balloon undilatable lesions (44.9%), followed by balloon uncrossable lesions (38.5%) and thrombotic lesions (14.1%) (Figure). The most common target vessel was the right coronary artery (33%) followed by the left anterior descending (32%) and circumflex (17%) artery. Treated lesions were highly complex with moderate/severe calcification in 75%, moderate/severe tortuosity in 38%, and were due to in-stent restenosis in 27%. Use of ELCA was associated with high technical (89.74%) and procedural (86.84%) success rates, and low incidence of major cardiac adverse events (MACE) (5.1%). Mean procedure time was 145 [interquartile range: 100, 214] min, fluoroscopy time was 37 [25, 66] min, high air kerma radiation dose was 3.26 [1.61, 6.16] Gray and contrast volume was 300 [245, 400] ml.
In a contemporary, single center US registry ELCA was used in highly complex lesions and was associated with high technical and procedural success rates and low incidence of MACE.
CORONARY: Atherectomy (excluding thrombectomy)