Direct Stenting in Patients Treated with Orbital Atherectomy: An ORBIT II Subanalysis.

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 20(6):454-460, 2019 06.PMID: 30982659Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Angioplasty, Balloon, Coronary/is [Instrumentation] | *Atherectomy, Coronary | *Coronary Artery Disease/th [Therapy] | *Stents | *Vascular Calcification/th [Therapy] | Aged | Aged, 80 and over | Angioplasty, Balloon, Coronary/ae [Adverse Effects] | Angioplasty, Balloon, Coronary/mo [Mortality] | Atherectomy, Coronary/ae [Adverse Effects] | Atherectomy, Coronary/mo [Mortality] | Coronary Artery Disease/dg [Diagnostic Imaging] | Coronary Artery Disease/mo [Mortality] | Feasibility Studies | Female | Humans | Male | Middle Aged | Risk Factors | Severity of Illness Index | Time Factors | Treatment Outcome | United States | Vascular Calcification/dg [Diagnostic Imaging] | Vascular Calcification/mo [Mortality]Year: 2019Local holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: BACKGROUND: Direct stenting offers many potential advantages in appropriately selected lesions. Coronary artery calcification increases the complexity and risk of adverse events associated with percutaneous coronary intervention. This study aimed to examine the feasibility of direct stenting after treatment with orbital atherectomy (OA).CONCLUSIONS: Orbital atherectomy facilitates direct stenting and is associated with high procedural success and favorable 3-year outcomes in carefully selected patients. Randomized studies are needed to assess the optimal strategy after lesion preparation with OA.Copyright (c) 2019 Elsevier Inc. All rights reserved.METHODS: ORBIT II was a single-arm trial enrolling 443 subjects with de novo severely calcified coronary lesions treated with OA; direct stenting was utilized in 59.0% of cases. Procedural outcomes and 3-year major adverse cardiac event (MACE) rates were compared in subjects treated with pre-stent balloon dilatation versus direct stenting after OA.RESULTS: Procedural success (84.2% vs. 93.3%; p=0.004) was significantly higher in the direct stenting cohort. 3-year MACE occurred less frequently in the direct stenting cohort (29.9% vs. 19.1%; p=0.006), driven by lower rates of myocardial infarction and target lesion revascularization. In a propensity matched analysis, procedural success and 3-year MACE rates were similar in the pre-stent balloon dilatation and direct stenting groups (85.0% vs. 91.8%; p=0.122 and 28.2% vs. 19.6%; p=0.078, respectively).All authors: Ali ZA, Behrens AN, Chambers JW, Lee MS, Martinsen BJ, Puma JA, Shlofmitz E, Shlofmitz RAOriginally published: Cardiovascular Revascularization Medicine. 2019 Mar 21Fiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-05-21
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30982659 Available 30982659

Available in print through MWHC library: 2002 - present

BACKGROUND: Direct stenting offers many potential advantages in appropriately selected lesions. Coronary artery calcification increases the complexity and risk of adverse events associated with percutaneous coronary intervention. This study aimed to examine the feasibility of direct stenting after treatment with orbital atherectomy (OA).

CONCLUSIONS: Orbital atherectomy facilitates direct stenting and is associated with high procedural success and favorable 3-year outcomes in carefully selected patients. Randomized studies are needed to assess the optimal strategy after lesion preparation with OA.

Copyright (c) 2019 Elsevier Inc. All rights reserved.

METHODS: ORBIT II was a single-arm trial enrolling 443 subjects with de novo severely calcified coronary lesions treated with OA; direct stenting was utilized in 59.0% of cases. Procedural outcomes and 3-year major adverse cardiac event (MACE) rates were compared in subjects treated with pre-stent balloon dilatation versus direct stenting after OA.

RESULTS: Procedural success (84.2% vs. 93.3%; p=0.004) was significantly higher in the direct stenting cohort. 3-year MACE occurred less frequently in the direct stenting cohort (29.9% vs. 19.1%; p=0.006), driven by lower rates of myocardial infarction and target lesion revascularization. In a propensity matched analysis, procedural success and 3-year MACE rates were similar in the pre-stent balloon dilatation and direct stenting groups (85.0% vs. 91.8%; p=0.122 and 28.2% vs. 19.6%; p=0.078, respectively).

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