Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description

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Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions : First Description. / Ali, Ziad A.; Brinton, Todd J.; Hill, Jonathan M.; Maehara, Akiko; Matsumura, Mitsuaki; Karimi Galougahi, Keyvan; Illindala, Uday; Götberg, Matthias; Whitbourn, Robert; Van Mieghem, Nicolas; Meredith, Ian T.; Di Mario, Carlo; Fajadet, Jean.

In: JACC: Cardiovascular Imaging, Vol. 10, No. 8, 01.08.2017, p. 897-906.

Research output: Contribution to journalArticle

Harvard

Ali, ZA, Brinton, TJ, Hill, JM, Maehara, A, Matsumura, M, Karimi Galougahi, K, Illindala, U, Götberg, M, Whitbourn, R, Van Mieghem, N, Meredith, IT, Di Mario, C & Fajadet, J 2017, 'Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description', JACC: Cardiovascular Imaging, vol. 10, no. 8, pp. 897-906. https://doi.org/10.1016/j.jcmg.2017.05.012

APA

Ali, Z. A., Brinton, T. J., Hill, J. M., Maehara, A., Matsumura, M., Karimi Galougahi, K., Illindala, U., Götberg, M., Whitbourn, R., Van Mieghem, N., Meredith, I. T., Di Mario, C., & Fajadet, J. (2017). Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description. JACC: Cardiovascular Imaging, 10(8), 897-906. https://doi.org/10.1016/j.jcmg.2017.05.012

CBE

Ali ZA, Brinton TJ, Hill JM, Maehara A, Matsumura M, Karimi Galougahi K, Illindala U, Götberg M, Whitbourn R, Van Mieghem N, Meredith IT, Di Mario C, Fajadet J. 2017. Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description. JACC: Cardiovascular Imaging. 10(8):897-906. https://doi.org/10.1016/j.jcmg.2017.05.012

MLA

Vancouver

Author

Ali, Ziad A. ; Brinton, Todd J. ; Hill, Jonathan M. ; Maehara, Akiko ; Matsumura, Mitsuaki ; Karimi Galougahi, Keyvan ; Illindala, Uday ; Götberg, Matthias ; Whitbourn, Robert ; Van Mieghem, Nicolas ; Meredith, Ian T. ; Di Mario, Carlo ; Fajadet, Jean. / Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions : First Description. In: JACC: Cardiovascular Imaging. 2017 ; Vol. 10, No. 8. pp. 897-906.

RIS

TY - JOUR

T1 - Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions

T2 - First Description

AU - Ali, Ziad A.

AU - Brinton, Todd J.

AU - Hill, Jonathan M.

AU - Maehara, Akiko

AU - Matsumura, Mitsuaki

AU - Karimi Galougahi, Keyvan

AU - Illindala, Uday

AU - Götberg, Matthias

AU - Whitbourn, Robert

AU - Van Mieghem, Nicolas

AU - Meredith, Ian T.

AU - Di Mario, Carlo

AU - Fajadet, Jean

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objectives This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT). Background The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e., lithoplasty) for vessel preparation before stent implantation. Methods We analyzed OCT findings in 31 patients in whom lithoplasty was used to treat severely calcified stenotic coronary lesions. Results After lithoplasty, intraplaque calcium fracture was identified in 43% of lesions, with circumferential multiple fractures noted in >25%. The frequency of calcium fractures per lesion increased in the most severely calcified plaques (highest tertile vs. lowest tertile; p = 0.009), with a trend toward greater incidence of calcium fracture (77.8% vs. 22.2%; p = 0.057). Post-lithoplasty, mean acute area gain was 2.1 mm2, which further increased with stent implantation, achieving a minimal stent area of 5.94 ± 1.98 mm2 and mean stent expansion of 112.0 ± 37.2%. Deep dissections, as part of the angioplasty effect, occurred in 13% of cases and were successfully treated with stent implantation without incidence of acute closure, slow flow/no reflow, or perforation. Conclusions High-resolution imaging by OCT delineated calcium modification with fracture as a major mechanism of action of lithoplasty in vivo and demonstrated efficacy in the achievement of significant acute area gain and favorable stent expansion.

AB - Objectives This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT). Background The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e., lithoplasty) for vessel preparation before stent implantation. Methods We analyzed OCT findings in 31 patients in whom lithoplasty was used to treat severely calcified stenotic coronary lesions. Results After lithoplasty, intraplaque calcium fracture was identified in 43% of lesions, with circumferential multiple fractures noted in >25%. The frequency of calcium fractures per lesion increased in the most severely calcified plaques (highest tertile vs. lowest tertile; p = 0.009), with a trend toward greater incidence of calcium fracture (77.8% vs. 22.2%; p = 0.057). Post-lithoplasty, mean acute area gain was 2.1 mm2, which further increased with stent implantation, achieving a minimal stent area of 5.94 ± 1.98 mm2 and mean stent expansion of 112.0 ± 37.2%. Deep dissections, as part of the angioplasty effect, occurred in 13% of cases and were successfully treated with stent implantation without incidence of acute closure, slow flow/no reflow, or perforation. Conclusions High-resolution imaging by OCT delineated calcium modification with fracture as a major mechanism of action of lithoplasty in vivo and demonstrated efficacy in the achievement of significant acute area gain and favorable stent expansion.

KW - calcification

KW - coronary artery disease

KW - intravascular imaging

KW - optical coherence tomography

UR - http://www.scopus.com/inward/record.url?scp=85026890947&partnerID=8YFLogxK

U2 - 10.1016/j.jcmg.2017.05.012

DO - 10.1016/j.jcmg.2017.05.012

M3 - Article

C2 - 28797412

AN - SCOPUS:85026890947

VL - 10

SP - 897

EP - 906

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

SN - 1876-7591

IS - 8

ER -