Cath Lab Digest - April 2008 - (Page 11)

11 Ultimately, the Diamondback is a promising new methodology for treating symptomatic PAD within the major and branch arteries of the leg. I remain optimistic that new and emerging technologies like the Diamondback will ultimately increase our ability to provide even more safe and effective treatment for patients with complex peripheral arterial disease and significant comorbidities. Final note: This year at C3 2008, an entire symposium is devoted to the orbital atherectomy technology, coupled with live case demonstrations. Experienced operators will discuss their experiences with orbital atherectomy, and we will have many other sessions of interest to endovascular physicians. For more information, visit www.C3conference.net. Dr. Dave can be contacted at rdintervention@yahoo.com Fibrocalcific plaque jeopardizes stent expansion in many lesions, and it is my opinion that an atherectomy procedure improves long-term results regardless of whether you plan on stent placement. stent mal-expansion and fractures are more common, the Diamondback can improve stenting results. If I can get a stent-like result, as shown in a recent superficial femoral artery (SFA) case (Figures 4a–4e), I will avoid stenting. There are multiple other patient subsets, such as diabetics with small vessels or patients with challenging femoropopliteal segments, in which stenting is undesirable. In these cases, orbital atherectomy provides an excellent tool to achieve an acceptable result, without the need for adjunctive therapy. Have you used this device in abovethe-knee arteries — the SFA or popliteal? Yes. I have found it extremely helpful in complex calcified SFA/ popliteal arteries. With the availability of the solid crown, my experience is growing in above-the-knee vessels. Fibrocalcific disease is extremely common at the adductor canal and in the popliteal artery where stenting results are poor. In fact, all nitinol stent trials exclude patients with popliteal disease at the knee joint. The Diamondback is an excellent tool to address that subset of patients — especially the diabetic patient with calcific disease — above, at and below the knee. Can you describe the learning curve? In my opinion, the Diamondback device is very easy to use, and the console interface is user friendly. In fact, the first time I ever used the device was for a live case demonstration at the Capital Cardiovascular Conference (C3) 2007 meeting. The angiographic and clinical results in a very complex distal popliteal occlusion were excellent. I was impressed with the performance of the ViperWire guidewire and angiographic outcome. This case is available as a live case archive on the website at www.C3conference.net. http://www.C3conference.net http://www.bairhugger.com http://www.C3conference.net http://www.bairhugger.com

Table of Contents Feed for the Digital Edition of Cath Lab Digest - April 2008

Cath Lab Digest - April 2008 Kaiser San Rafael Medical Center Orbital Atherectomy: A New Treatment for Complex Peripheral Arterial Disease Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Contents Clinical Editor’s Corner CEU Education Center The Missing Link in STEMI Interventions — Thrombus Aspiration during Primary Percutaneous Coronary Intervention Predicting Stent Thrombosis Using A Clinical Risk Score Use of a New Guidewire: The Tigerwire Should I Stay or Should I Go? Weighing Options for New Opportunities Navigating Tortuous Coronary Sinus Anatomy Using a Bipolar Lead The National Society of Radiology Practitioner Assistants (NSRPA) Holds 9th Annual Educational Conference For Medical Imaging Physician Extenders and Mid-Level Healthcare Providers Cath Lab & Beyond: A Meeting Update The Ten-Minute Interview with… Dale Hansen RT, CVT Sometimes, You Just Know Twin Circumflex Arteries: A Rare Coronary Artery Anomaly What Do You Think? Meetings Calendar News from the American College of Cardiology (ACC) Scientific Session and the Society of Cardiovascular Angiography & Interventions (SCAI) Annual Scientific Sessions in Partnership with the ACC i2 Summit Clinical & Industry News Cath Laughs Classifieds Advertisers Index

Cath Lab Digest - April 2008

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