Indications and outcomes of excimer laser coronary atherectomy: Efficacy and safety for thrombotic lesions—The ULTRAMAN registry

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• 作者：Masami Nishino ; MD ; PhD ; FJCC^a ; ^{mnishino@orh.go.jp} ; Naoki Mori ; MD^a ; Shin Takiuchi ; MD ; PhD^b ; Daisuke Shishikura ; MD^b ; Naofumi Doi ; MD ; PhD^c ; Toru Kataoka ; MD ; PhD^d ; Takayuki Ishihara ; MD^e ; Noriyuki Kinoshita ; MD ; PhD^f ; for the ULTRAMAN Registry investigators¹
• 关键词：Coronary artery disease ; Coronary intervention ; Laser ; Acute coronary syndrome ; In-stent restenosis
• 刊名：Journal of Cardiology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：69
• 期：1
• 页码：314-319
• 全文大小：585 K
• 卷排序：69

文摘

Excimer laser coronary atherectomy (ELCA) recently became available in Japan, but ELCA's effectiveness and safety are not clear.Methods and resultsWe enrolled consecutive patients who underwent ELCA and were registered in the Utility of Laser for Transcatheter Atherectomy—Multicenter Analysis around Naniwa (ULTRAMAN) registry comprising six Japanese medical centers around Naniwa in Japan with patients registered from April 2006 to June 2015. We evaluated the catheter sizes used and compared the success rate, thrombolysis in myocardial infarction (TIMI) flow, blush score, and complications between the rich-thrombus (RT) group [acute coronary syndrome (ACS) and saphenous vein graft (SVG)] and the poor-thrombus (PT) group [in-stent restenosis (ISR), chronic total occlusion (CTO), calcification, and long or bifurcation (L&B) lesions]. Of the 328 patients, 6 (1.8%) were treated for an SVG, 175 (53.4%) were treated for ACS, 18 (5.5%) for CTO, 106 (32.4%) for ISR, 8 (2.4%) for calcification, and 15 for L&B lesions (4.6%). A 1.7-mm (concentric)-diameter ELCA catheter was used most frequently (59.4%). High success rates were achieved in both the RT and PT groups, but the TIMI flow grade and blush score were significantly lower and the complications rate was significantly higher in the RT group (n = 181).ConclusionsIn Japan, the major indications for ELCA have been ACS and ISR. ELCA can provide a safe and effective treatment even for RT lesions.