How should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsy
Heavily calcified and densely fibrotic coronary lesions continue to represent a challenge for percutaneous coronary intervention (PCI), as they are difficult to dilate, and it is difficult to deliver and implant drug-eluting stents (DES) properly. Poor stent deployment is associated with high rates...
| Автори: | , , , , , , |
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| Формат: | Journal article |
| Мова: | English |
| Опубліковано: |
Elsevier
2019
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| _version_ | 1826280558460665856 |
|---|---|
| author | Kassimis, G Raina, T Kontogiannis, N Patri, G Abramik, J Zaphiriou, A Banning, A |
| author_facet | Kassimis, G Raina, T Kontogiannis, N Patri, G Abramik, J Zaphiriou, A Banning, A |
| author_sort | Kassimis, G |
| collection | OXFORD |
| description | Heavily calcified and densely fibrotic coronary lesions continue to represent a challenge for percutaneous coronary intervention (PCI), as they are difficult to dilate, and it is difficult to deliver and implant drug-eluting stents (DES) properly. Poor stent deployment is associated with high rates of periprocedural complications and suboptimal long-term clinical outcomes. Thanks to the introduction of several adjunctive PCI tools, like cutting and scoring balloons, atherectomy devices, and to the novel intravascular lithotripsy technology, the treatment of such lesions has become increasingly feasible, predictable and safe. A step-wise progression of strategies is described for coronary plaque modification, from well-recognised techniques to techniques that should only be considered when standard manoeuvres have proven unsuccessful. We highlight these techniques in the setting of clinical examples how best to apply them through better patient and lesion selection, with the main objective of optimising DES delivery and implantation, and subsequent improved outcomes. |
| first_indexed | 2024-03-07T00:15:29Z |
| format | Journal article |
| id | oxford-uuid:7ab35c04-535c-49bf-9b38-7bfa5f48f644 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:15:29Z |
| publishDate | 2019 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:7ab35c04-535c-49bf-9b38-7bfa5f48f6442022-03-26T20:45:43ZHow should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7ab35c04-535c-49bf-9b38-7bfa5f48f644EnglishSymplectic Elements at OxfordElsevier2019Kassimis, GRaina, TKontogiannis, NPatri, GAbramik, JZaphiriou, ABanning, AHeavily calcified and densely fibrotic coronary lesions continue to represent a challenge for percutaneous coronary intervention (PCI), as they are difficult to dilate, and it is difficult to deliver and implant drug-eluting stents (DES) properly. Poor stent deployment is associated with high rates of periprocedural complications and suboptimal long-term clinical outcomes. Thanks to the introduction of several adjunctive PCI tools, like cutting and scoring balloons, atherectomy devices, and to the novel intravascular lithotripsy technology, the treatment of such lesions has become increasingly feasible, predictable and safe. A step-wise progression of strategies is described for coronary plaque modification, from well-recognised techniques to techniques that should only be considered when standard manoeuvres have proven unsuccessful. We highlight these techniques in the setting of clinical examples how best to apply them through better patient and lesion selection, with the main objective of optimising DES delivery and implantation, and subsequent improved outcomes. |
| spellingShingle | Kassimis, G Raina, T Kontogiannis, N Patri, G Abramik, J Zaphiriou, A Banning, A How should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsy |
| title | How should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsy |
| title_full | How should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsy |
| title_fullStr | How should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsy |
| title_full_unstemmed | How should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsy |
| title_short | How should we treat heavily calcified coronary artery disease in contemporary practice? From atherectomy to intravascular lithotripsy |
| title_sort | how should we treat heavily calcified coronary artery disease in contemporary practice from atherectomy to intravascular lithotripsy |
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