Indications and outcomes of excimer laser coronary atherectomy: Efficacy and safety for thrombotic lesions—The ULTRAMAN registry. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Nishino, Masami; Mori, Naoki; Takiuchi, Shin; Shishikura, Daisuke; Doi, Naofumi; Kataoka, Toru; Ishihara, Takayuki; Kinoshita, Noriyuki
• Is Part Of: Journal of cardiology. Volume 69:Issue 1(2017:Jan.)
• Page Start: 314
• Page End: 319
• Publication Date: 2017-01
• Subjects: Coronary artery disease -- Coronary intervention -- Laser -- Acute coronary syndrome -- In-stent restenosis; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2016.05.018
• Languages: English
• ISSNs: 0914-5087

Abstract

Abstract: Background: Excimer laser coronary atherectomy (ELCA) recently became available in Japan, but ELCA's effectiveness and safety are not clear. Methods and results: We enrolled consecutive patients who underwent ELCA and were registered in theU tility ofL aser forTr anscatheterA therectomy—M ulticenterA nalysis aroundN aniwa (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). Conclusions: In Japan, the major indications for ELCA have been ACS and ISR. ELCA can provide a safe and effective treatment even for RT lesions.