Orbital atherectomy as an adjunct to debulk difficult calcified lesions prior to mesenteric artery stenting

Jesse M. Manunga, Gustavo Oderich

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: To describe a technique in which percutaneous orbital atherectomy is used to debulk heavily calcified superior mesenteric artery (SMA) occlusions as an adjunct in patients undergoing angioplasty and stenting. Technique: The technique is demonstrated in a 62-year-old woman with a replaced right hepatic artery originating from an SMA occluded by densely calcified lesions. Via a left transbrachial approach, a 7-F MPA guide catheter was used to engage the ostium of the SMA, which was crossed using a catheter and guidewire. The calcified lesion was debulked using the 2-mm Diamondback 360° orbital atherectomy system. The wire was exchanged for a 0.014-inch filter wire and 0.018-inch guidewire. Using a 2-guidewire technique, the SMA was stented with a self-expanding stent for the distal lesion that crossed side branches and a balloon-expandable stent at the ostium. A 0.014-inch guidewire was placed into the replaced hepatic artery through a cell of the self-expanding stent, followed by deployment of a small balloon-expandable stent to address the residual lesion. Conclusion: The use of orbital atherectomy to debulk occluded and heavily calcified SMA lesions may optimize the technical results with angioplasty and stenting.

Original languageEnglish (US)
Pages (from-to)489-494
Number of pages6
JournalJournal of Endovascular Therapy
Volume19
Issue number4
DOIs
StatePublished - Aug 28 2012

Fingerprint

Atherectomy
Mesenteric Arteries
Superior Mesenteric Artery
Stents
Hepatic Artery
Angioplasty
Catheters

Keywords

  • Calcification
  • Occlusion
  • Orbital atherectomy
  • Stent
  • Superior mesenteric artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Orbital atherectomy as an adjunct to debulk difficult calcified lesions prior to mesenteric artery stenting. / Manunga, Jesse M.; Oderich, Gustavo.

In: Journal of Endovascular Therapy, Vol. 19, No. 4, 28.08.2012, p. 489-494.

Research output: Contribution to journalArticle

@article{567d9ff93fc644f4844afdd9fa8f1959,
title = "Orbital atherectomy as an adjunct to debulk difficult calcified lesions prior to mesenteric artery stenting",
abstract = "Purpose: To describe a technique in which percutaneous orbital atherectomy is used to debulk heavily calcified superior mesenteric artery (SMA) occlusions as an adjunct in patients undergoing angioplasty and stenting. Technique: The technique is demonstrated in a 62-year-old woman with a replaced right hepatic artery originating from an SMA occluded by densely calcified lesions. Via a left transbrachial approach, a 7-F MPA guide catheter was used to engage the ostium of the SMA, which was crossed using a catheter and guidewire. The calcified lesion was debulked using the 2-mm Diamondback 360° orbital atherectomy system. The wire was exchanged for a 0.014-inch filter wire and 0.018-inch guidewire. Using a 2-guidewire technique, the SMA was stented with a self-expanding stent for the distal lesion that crossed side branches and a balloon-expandable stent at the ostium. A 0.014-inch guidewire was placed into the replaced hepatic artery through a cell of the self-expanding stent, followed by deployment of a small balloon-expandable stent to address the residual lesion. Conclusion: The use of orbital atherectomy to debulk occluded and heavily calcified SMA lesions may optimize the technical results with angioplasty and stenting.",
keywords = "Calcification, Occlusion, Orbital atherectomy, Stent, Superior mesenteric artery",
author = "Manunga, {Jesse M.} and Gustavo Oderich",
year = "2012",
month = "8",
day = "28",
doi = "10.1583/12-3900.1",
language = "English (US)",
volume = "19",
pages = "489--494",
journal = "Journal of Endovascular Therapy",
issn = "1526-6028",
publisher = "International Society of Endovascular Specialists",
number = "4",

}

TY - JOUR

T1 - Orbital atherectomy as an adjunct to debulk difficult calcified lesions prior to mesenteric artery stenting

AU - Manunga, Jesse M.

AU - Oderich, Gustavo

PY - 2012/8/28

Y1 - 2012/8/28

N2 - Purpose: To describe a technique in which percutaneous orbital atherectomy is used to debulk heavily calcified superior mesenteric artery (SMA) occlusions as an adjunct in patients undergoing angioplasty and stenting. Technique: The technique is demonstrated in a 62-year-old woman with a replaced right hepatic artery originating from an SMA occluded by densely calcified lesions. Via a left transbrachial approach, a 7-F MPA guide catheter was used to engage the ostium of the SMA, which was crossed using a catheter and guidewire. The calcified lesion was debulked using the 2-mm Diamondback 360° orbital atherectomy system. The wire was exchanged for a 0.014-inch filter wire and 0.018-inch guidewire. Using a 2-guidewire technique, the SMA was stented with a self-expanding stent for the distal lesion that crossed side branches and a balloon-expandable stent at the ostium. A 0.014-inch guidewire was placed into the replaced hepatic artery through a cell of the self-expanding stent, followed by deployment of a small balloon-expandable stent to address the residual lesion. Conclusion: The use of orbital atherectomy to debulk occluded and heavily calcified SMA lesions may optimize the technical results with angioplasty and stenting.

AB - Purpose: To describe a technique in which percutaneous orbital atherectomy is used to debulk heavily calcified superior mesenteric artery (SMA) occlusions as an adjunct in patients undergoing angioplasty and stenting. Technique: The technique is demonstrated in a 62-year-old woman with a replaced right hepatic artery originating from an SMA occluded by densely calcified lesions. Via a left transbrachial approach, a 7-F MPA guide catheter was used to engage the ostium of the SMA, which was crossed using a catheter and guidewire. The calcified lesion was debulked using the 2-mm Diamondback 360° orbital atherectomy system. The wire was exchanged for a 0.014-inch filter wire and 0.018-inch guidewire. Using a 2-guidewire technique, the SMA was stented with a self-expanding stent for the distal lesion that crossed side branches and a balloon-expandable stent at the ostium. A 0.014-inch guidewire was placed into the replaced hepatic artery through a cell of the self-expanding stent, followed by deployment of a small balloon-expandable stent to address the residual lesion. Conclusion: The use of orbital atherectomy to debulk occluded and heavily calcified SMA lesions may optimize the technical results with angioplasty and stenting.

KW - Calcification

KW - Occlusion

KW - Orbital atherectomy

KW - Stent

KW - Superior mesenteric artery

UR - http://www.scopus.com/inward/record.url?scp=84865302608&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865302608&partnerID=8YFLogxK

U2 - 10.1583/12-3900.1

DO - 10.1583/12-3900.1

M3 - Article

VL - 19

SP - 489

EP - 494

JO - Journal of Endovascular Therapy

JF - Journal of Endovascular Therapy

SN - 1526-6028

IS - 4

ER -