Contemporary Use of Laser During Percutaneous Coronary Interventions: Insights from the Laser Veterans Affairs (LAVA) Multicenter Registry

Judit Karacsonyi, Ehrin J. Armstrong, Huu Tam D. Truong, Ryan Tsuda, Damianos G. Kokkinidis, Jose Roberto Martinez-Parachini, Aya J. Alame, Barbara A. Danek, Aris Karatasakis, Michele Roesle, Houman Khalili, Imre Ungi, Subhash Banerjee, Emmanouil S. Brilakis, Bavana V. Rangan

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background: The contemporary use and outcomes of excimer laser coronary atherectomy (ELCA) in percutaneous coronary intervention (PCI) are not well described. Methods: We examined the baseline clinical and angiographic characteristics and procedural outcomes of 130 target lesions in 121 consecutive PCIs (n ≤ 116 patients) in which ELCA was performed at three United States Department of Veterans Affairs (VA) medical centers between 2008 and 2016. Results: Mean age was 68.5 ± 9 years and 97% of the patients were men. Patients had high prevalence of diabetes mellitus (63%), prior coronary artery bypass graft surgery (41%), and prior myocardial infarction (60%). The most common target vessel was the left anterior descending (32%), followed by the right coronary artery (30%), circumflex artery (20%), and saphenous vein graft (12%). The target lesions were highly complex, with moderate/severe calcification in 62% and in-stent restenosis in 37%. The most common indication for ELCA was balloon-uncrossable lesions (43.8%), followed by balloon-undilatable lesions (40.8%) and thrombotic lesions (12.3%). Use of ELCA was associated with high technical success rate (90.0%) and procedural success rate (88.8%), and low major adverse cardiac event (MACE) rate (3.45%). Mean procedure time was 120 min (interquartile range [IQR], 81-191 min), air kerma radiation dose was 2.76 Gy (IQR, 1.32-5.01 Gy), and contrast volume was 273 mL (IQR, 201-362 mL). Conclusion: In a contemporary multicenter United States registry, ELCA was commonly used in highly complex lesions and was associated with high technical and procedural success rates and low incidence of MACE.

Original languageEnglish (US)
Pages (from-to)195-201
Number of pages7
JournalJournal of Invasive Cardiology
Volume30
Issue number6
StatePublished - Jun 1 2018

Keywords

  • atherectomy
  • laser
  • percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Karacsonyi, J., Armstrong, E. J., Truong, H. T. D., Tsuda, R., Kokkinidis, D. G., Martinez-Parachini, J. R., Alame, A. J., Danek, B. A., Karatasakis, A., Roesle, M., Khalili, H., Ungi, I., Banerjee, S., Brilakis, E. S., & Rangan, B. V. (2018). Contemporary Use of Laser During Percutaneous Coronary Interventions: Insights from the Laser Veterans Affairs (LAVA) Multicenter Registry. Journal of Invasive Cardiology, 30(6), 195-201.