TY  - BOOK
AU  - Shlofmitz, Evan
TI  - Direct Stenting in Patients Treated with Orbital Atherectomy: An ORBIT II Subanalysis
SN  - 1878-0938
PY  - 2019///
KW  - *Angioplasty, Balloon, Coronary/is [Instrumentation]
KW  - *Atherectomy, Coronary
KW  - *Coronary Artery Disease/th [Therapy]
KW  - *Stents
KW  - *Vascular Calcification/th [Therapy]
KW  - Aged
KW  - Aged, 80 and over
KW  - Angioplasty, Balloon, Coronary/ae [Adverse Effects]
KW  - Angioplasty, Balloon, Coronary/mo [Mortality]
KW  - Atherectomy, Coronary/ae [Adverse Effects]
KW  - Atherectomy, Coronary/mo [Mortality]
KW  - Coronary Artery Disease/dg [Diagnostic Imaging]
KW  - Coronary Artery Disease/mo [Mortality]
KW  - Feasibility Studies
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - Time Factors
KW  - Treatment Outcome
KW  - United States
KW  - Vascular Calcification/dg [Diagnostic Imaging]
KW  - Vascular Calcification/mo [Mortality]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available in print through MWHC library: 2002 - present
N2  - 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)
UR  - https://dx.doi.org/10.1016/j.carrev.2019.03.011
ER  -