04519nam a22007217a 4500008004200000022001400042040002000056245022300076251008200299252005500381253005600436260000900492260001100501266001500512520186300527546001202390650003802402650005002440650003302490650004202523650004602565650003502611650003702646650000902683650003702692650004902729650001102778650004302789650003302832650003702865650002702902650001102929650004102940650000902981650001602990650005603006650002803062650004503090650003503135650003003170650002403200650001503224650002203239650001803261650005303279650004303332651003903375657002003414700001703434700002003451700001503471700001903486700002303505700002803528700002403556700002003580700001703600700002203617700002403639700002203663700001703685856009503702170929s20182018 xxu||||| |||| 00| 0 eng d a1569-5794 aOvid MEDLINE(R) aIntravascular ultrasound assessment of the effect of laser energy on the arterial wall during the treatment of femoro-popliteal lesions: a CliRpath excimer laser system to enlarge lumen openings (CELLO) registry study. aThe International Journal of Cardiovascular Imaging. 34(3):345-352, 2018 Mar. aInt J Cardiovasc Imaging. 34(3):345-352, 2018 Mar. aThe international journal of cardiovascular imaging c2018 fFY2018 d2017-09-29 aThe CliRpath Excimer Laser System to Enlarge Lumen Openings (CELLO) registry included patients treated with modified excimer laser catheters for the endovascular treatment of peripheral artery disease affecting the superficial femoral artery (SFA) and proximal popliteal artery. The aim of this study was to assess, via intravascular ultrasound (IVUS) the dissections in the vessel wall following treatment with the laser catheters. IVUS grayscale images from the CELLO registry were systematically reviewed for dissections in the treated vessel segments by two investigators. Images from 33 patients; 66 pullbacks (1867 IVUS frames in 2 phases), were successfully matched frame-to-frame to evaluate identical segments of the treated vessels in the two phases; post-2 mm Turbo-Elite laser pilot channel creation and post Turbo-Booster laser atherectomy. Dissections were categorized as; (1) intimal, (2) medial, (3) intramural hematoma, and (4) adventitial according to the ACC Clinical Expert Consensus Document classification of dissections. An average of 57 frames was evaluated per pullback, giving a total of 3734 frames (1867 matched for pre-ablation (post channel creation) and post-ablation phases). Treatments with the modified Excimer laser catheters resulted in a significant increase in lumen area of 5.5+/-3.2-mm2 (95% CI 4.3-6.8, p<0.0001) and reduction in plaque plus media volume of -10.6+/-36.0 mm3 (95% CI -25.8 to 4.6, p=0.1619) whilst giving rise to mainly intramural hematoma formations post Turbo-Booster laser treatment in 55% of frames assessed and 24% medial dissections with less than 1% adventitial disruption. The Excimer laser based Turbo-Booster treatment of peripheral artery lesions resulted in significant plaque debulking and increased lumen diameter with negligible degree of adventitial layer injury. aEnglish a*Atherectomy/is [Instrumentation] a*Endovascular Procedures/is [Instrumentation] a*Femoral Artery/su [Surgery] a*Lasers, Excimer/tu [Therapeutic Use] a*Peripheral Arterial Disease/su [Surgery] a*Popliteal Artery/su [Surgery] a*Ultrasonography, Interventional aAged aAtherectomy/ae [Adverse Effects] aEndovascular Procedures/ae [Adverse Effects] aFemale aFemoral Artery/dg [Diagnostic Imaging] aFemoral Artery/in [Injuries] aHematoma/dg [Diagnostic Imaging] aHematoma/et [Etiology] aHumans aLasers, Excimer/ae [Adverse Effects] aMale aMiddle Aged aPeripheral Arterial Disease/dg [Diagnostic Imaging] aPlaque, Atherosclerotic aPopliteal Artery/dg [Diagnostic Imaging] aPopliteal Artery/in [Injuries] aPredictive Value of Tests aProspective Studies aRegistries aTreatment Outcome aUnited States aVascular System Injuries/dg [Diagnostic Imaging] aVascular System Injuries/et [Etiology] aMedStar Heart & Vascular Institute aJournal Article aAzizi, Viana aBeyene, Solomon aBui, Anh B aDesale, Sameer aDheendsa, Aaphtaab aGarcia-Garcia, Hector M aKajita, Alexandre H aKoifman, Edward aKuku, Kayode aMeirovich, Yael F aMelaku, Gebremedhin aSchneider, Blaine aWaksman, Ron uhttps://dx.doi.org/10.1007/s10554-017-1248-2zhttps://dx.doi.org/10.1007/s10554-017-1248-2