TY - JOUR
T1 - Intravascular ultrasound assessment of the effect of laser energy on the arterial wall during the treatment of femoro-popliteal lesions
T2 - a CliRpath excimer laser system to enlarge lumen openings (CELLO) registry study
AU - On behalf of the CELLO study investigators
AU - Kuku, Kayode O.
AU - Garcia-Garcia, Hector M.
AU - Koifman, Edward
AU - Kajita, Alexandre H.
AU - Desale, Sameer
AU - Azizi, Viana
AU - Melaku, Gebremedhin
AU - Bui, Anh
AU - Meirovich, Yael F.
AU - Beyene, Solomon
AU - Dheendsa, Aaphtaab
AU - Schneider, Blaine
AU - Waksman, Ron
N1 - Funding Information:
Funding The post-hoc analyses was endorsed and partly funded by Spectranetics Corporation, Colorado Springs, Colorado.
Funding Information:
Special thanks to Spectranetics Corporation, MedStar Health Research Institute, Cardiovascular Core Laboratories and all the contributors from the original CELLO registry report. The post-hoc analyses was endorsed and partly funded by Spectranetics Corporation, Colorado Springs, Colorado. Blaine Schneider is the manager of Disease State Research at Spectranetics (manufacturer of the Turbo Elite and Turbo Booster laser devices). Ron Waksman reports personal fees from Biotronik, Medtronic, and Abbott Vascular; Grants and personal fees from Astra Zeneca and Boston Scientific; and Grants from The Medicines Company and Edwards Lifesciences.
Publisher Copyright:
© 2017, The Author(s).
PY - 2018/3/1
Y1 - 2018/3/1
N2 - The 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.
AB - The 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.
KW - Dissections
KW - Excimer laser atherectomy
KW - Femoro-popliteal
KW - Intravascular ultrasound
KW - Peripheral arterial disease
UR - http://www.scopus.com/inward/record.url?scp=85029904882&partnerID=8YFLogxK
U2 - 10.1007/s10554-017-1248-2
DO - 10.1007/s10554-017-1248-2
M3 - Article
C2 - 28952037
AN - SCOPUS:85029904882
SN - 1569-5794
VL - 34
SP - 345
EP - 352
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
IS - 3
ER -