Documento de posicionamiento de la ACI-SEC sobre la modificación de la placa en el tratamiento de las lesiones calcificadas

  1. Alfonso Jurado Román 1
  2. Antonio Gómez Menchero 2
  3. Nieves Gonzalo 3
  4. Javier Martín Moreiras 4
  5. Raymundo Ocaranza Sánchez 5
  6. Soledad Ojeda 6
  7. Jorge Palazuelos Molinero 7
  8. Oriol Rodríguez-Leor 8
  9. Pablo Salinas Sanguino 3
  10. Beatriz Vaquerizo Montilla 9
  11. Xavier Freixa 10
  12. Ana Belén Cid Álvarez 11
  1. 1 Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España
  2. 2 Servicio de Cardiología, Hospital Juan Ramón Jiménez, Huelva, España
  3. 3 Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, España
  4. 4 Servicio de Cardiología, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España
  5. 5 Servicio de Cardiología, Hospital Universitario Lucus Augusti, Lugo, España
  6. 6 Servicio de Cardiología, Hospital Universitario Reina Sofía, Universidad de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España
  7. 7 Servicio de Cardiología, Hospital La Luz, Madrid, España
  8. 8 Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
  9. 9 Servicio de Cardiología, Hospital del Mar, Barcelona, España
  10. 10 Institut Clínic Cardiovascular, Hospital Clínic, Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, España
  11. 11 Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, España
Mostrar afiliacións +
Revista:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Ano de publicación: 2023

Volume: 5

Número: 1

Páxinas: 46-61

Tipo: Artigo

DOI: 10.24875/RECIC.M22000342 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Outras publicacións en: REC: Interventional Cardiology

Resumo

La calcificación coronaria es probablemente el mayor determinante de un mal resultado de la angioplastia y se asocia a mayores tasas de eventos adversos. En la actualidad existen distintas técnicas de modificación de la placa basadas en balones o en dispositivos específicos. El conocimiento de sus características y su uso adecuado son aspectos clave para el tratamiento óptimo de las lesiones calcificadas. Este artículo de posicionamiento, promovido desde la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (ACI-SEC), describe las técnicas de modificación de la placa existentes en la actualidad y propone un algoritmo para el tratamiento de la lesión calcificada.

Referencias bibliográficas

  • 1. Mori H, Torii S, Kutyna M, Sakamoto A, Finn AV, Virmani R. Coronary Artery Calcification and its Progression: What Does it Really Mean? JACC Cardiovasc Imaging. 2018;11:127-142.
  • 2. Wang X, Matsumura M, Mintz GS, et al. In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography. JACC Cardiovasc Imaging. 2017;10:869-879.
  • 3. Copeland-Halperin RS, Baber U, Aquino M, et al. Prevalence, correlates, and impact of coronary calcification on adverse events following PCI with newer-generation DES: Findings from a large multiethnic registry. Catheter Cardiovasc Interv. 2018;91:859-866.
  • 4. Sharma SK, Bolduan RW, Patel MR, et al. Impact of calcification on percutaneous coronary intervention: MACE-Trial 1-year results. Catheter Cardiovasc Interv. 2019;94:187-194.
  • 5. Fujino A, Mintz GS, Matsumura M, et al. A new optical coherence tomography-based calcium scoring system to predict stent underexpansion. EuroIntervention. 2018;13:e2182-e2189.
  • 6. Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360:961-972.
  • 7. Kawashima H, Serruys PW, Hara H, et al. 10-Year All-Cause Mortality Following Percutaneous or Surgical Revascularization in Patients With Heavy Calcification. JACC Cardiovasc Interv. 2022;15:193-204.
  • 8. Hendry C, Fraser D, Eichhofer J, et al. Coronary perforation in the drug-eluting stent era: incidence, risk factors, management and outcome: the UK experience. EuroIntervention. 2012;8:79-86.
  • 9. Mintz GS, Popma JJ, Pichard AD, et al. Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions. Circulation. 1995;91:1959-1965.
  • 10. Zhang M, Matsumura M, Usui E, et al. Intravascular Ultrasound-Derived Calcium Score to Predict Stent Expansion in Severely Calcified Lesions. Circ Cardiovasc Interv. 2021; e010296.
  • 11. Stefanini GG, Alfonso F, Barbato E, et al. Management of Myocardial Revascularization Failure: An Expert Consensus Document of the EAPCI. EuroIntervention. 2020;16:e875-e890.
  • 12. Räber L, Mintz GS, Koskinas KC, et al. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. EuroIntervention. 2018;14:656-677.
  • 13. Cubero-Gallego H, Tizón-Marcos H, Vaquerizo B. Opciones actuales para el tratamiento de las lesiones calcificadas. REC Interv Cardiol. 2020;2:129-139.
  • 14. Hellig F, Pandie S, Barbato E, Colombo A, Heyndrickx JR. Rotational atherectomy. En: PCR - EAPCI Textbook 2015, Part III. Europa Digital & Publishing; 2015.
  • 15. Sharma SK, Tomey MI, Teirstein PS, et al. North American Expert Review of Rotational Atherectomy. Circ Cardiovasc Interv. 2019;12:e007448.
  • 16. Barbato E, Carrié D, Dardas P, et al. European expert consensus on rotational atherectomy. EuroIntervention. 2015;11:30-36.
  • 17. De Maria GL, Scarsini R, Banning AP. Management of Calcific Coronary Artery Lesions: Is it Time to Change Our Interventional Therapeutic Approach? JACC Cardiovasc Interv. 2019;12:1465-1478.
  • 18. Bittl JA, Chew DP, Topol EJ, Kong DF, Califf RM. Meta-analysis of randomized trials of percutaneous transluminal coronary angioplasty versus atherectomy, cutting balloon atherotomy, or laser angioplasty. J Am Coll Cardiol. 2004;43:936-942.
  • 19. Safian RD, Feldman T, Muller DW, et al. Coronary angioplasty and Rotablator atherectomy trial (CARAT): immediate and late results of a prospective multicenter randomized trial. Catheter Cardiovasc Interv. 2001;53:213-220.
  • 20. Abdel-Wahab M, Richardt G, Joachim Büttner H, et al. High-speed rotational atherectomy before paclitaxel-eluting stent implantation in complex calcified coronary lesions: the randomized ROTAXUS (Rotational Atherectomy Prior to Taxus Stent Treatment for Complex Native Coronary Artery Disease) trial. JACC Cardiovasc Interv. 2013;6:10-19.
  • 21. Abdel-Wahab M, Toelg R, Byrne RA, et al. High-Speed Rotational Atherectomy Versus Modified Balloons Prior to Drug-Eluting Stent Implantation in Severely Calcified Coronary Lesions. Circ Cardiovasc Interv. 2018;11:e007415.
  • 22. Iannaccone M, Piazza F, Boccuzzi GG, et al. ROTational AThErectomy in acute coronary syndrome: early and midterm outcomes from a multicentre registry. EuroIntervention. 2016;12:1457-1464.
  • 23. Kawamoto H, Latib A, Ruparelia N, et al. In-hospital and midterm clinical outcomes of rotational atherectomy followed by stent implantation: the ROTATE multicentre registry. EuroIntervention. 2016;12:1448-1456.
  • 24. de Waha S, Allali A, Büttner HJ, et al. Rotational atherectomy before paclitaxel-eluting stent implantation in complex calcified coronary lesions: Two-year clinical outcome of the randomized ROTAXUS trial. Catheter Cardiovasc Interv. 2016;87:691-700.
  • 25. Cardiovascular System (CSI). Diamondback 360 Coronary Orbital Atherectomy System. Disponible en: https://csi360.com/diamondback-coronary-orbital-atherectomy-system/. Consultado 27 sep 2022.
  • 26. Shlofmitz E, Shlofmitz R, Lee MS. Orbital Atherectomy: A Comprehensive Review. Interv Cardiol Clin. 2019;8:161-171.
  • 27. Yamamoto MH, Maehara A, Karimi Galougahi K, et al. Mechanisms of Orbital Versus Rotational Atherectomy Plaque Modification in Severely Calcified Lesions Assessed by Optical Coherence Tomography. JACC Cardiovasc Interv. 2017;10:2584-2586.
  • 28. Chambers JW, Feldman RL, Himmelstein SI, et al. Pivotal trial to evaluate the safety and efficacy of the orbital atherectomy system in treating de novo, severely calcified coronary lesions (ORBIT II). JACC Cardiovasc Interv. 2014;7:510-518.
  • 29. Redfors B, Sharma SK, Saito S, et al. Novel Micro Crown Orbital Atherectomy for Severe Lesion Calcification: Coronary Orbital Atherectomy System Study (COAST). Circ Cardiovasc Interv. 2020;13:e008993.
  • 30. Parikh K, Chandra P, Choksi N, Khanna P, Chambers J. Safety and feasibility of orbital atherectomy for the treatment of calcified coronary lesions: the ORBIT I trial. Catheter Cardiovasc Interv. 2013;81:1134-1139.
  • 31. Lee M, Généreux P, Shlofmitz R, et al. Orbital atherectomy for treating de novo, severely calcified coronary lesions: 3-year results of the pivotal ORBIT II trial. Cardiovasc Revasc Med. 2017;18:261-264.
  • 32. Tsutsui RS, Sammour Y, Kalra A, et al. Excimer Laser Atherectomy in Percutaneous Coronary Intervention: A Contemporary Review. Cardiovasc Revasc Med. 2021;25:75-85.
  • 33. Golino L, Caiazzo G, Calabrò P, et al. Excimer laser technology in percutaneous coronary interventions: Cardiovascular laser society’s position paper. Int J Cardiol. 2022;350:19-26.
  • 34. Ojeda S, Azzalini L, Suárez de Lezo J, et al. Excimer laser coronary atherectomy for uncrossable coronary lesions. A multicenter registry. Catheter Cardiovasc Interv. 2021;98:1241-1249.
  • 35. Mintz GS, Kovach JA, Javier SP, et al. Mechanisms of lumen enlargement after excimer laser coronary angioplasty. An intravascular ultrasound study. Circulation. 1995;92:3408-3414.
  • 36. Fernandez JP, Hobson AR, McKenzie D, et al. Beyond the balloon: excimer coronary laser atherectomy used alone or in combination with rotational atherectomy in the treatment of chronic total occlusions, non-crossable and non-expansible coronary lesions. EuroIntervention. 2013;9:243-250.
  • 37. Latib A, Takagi K, Chizzola G, et al. Excimer Laser LEsion modification to expand non-dilatable stents: the ELLEMENT registry. Cardiovasc Revasc Med. 2014;15:8-12.
  • 38. Sintek M, Coverstone E, Bach R, et al. Excimer Laser Coronary Angioplasty in Coronary Lesions: Use and Safety From the NCDR/CATH PCI Registry. Circ Cardiovasc Interv. 2021;14(7):e010061.
  • 39. Protty MB, Hussain HI, Gallagher S, et al. Excimer laser coronary atherectomy during complex PCI: An analysis of 1,471 laser cases from the British Cardiovascular Intervention Society database. Catheter Cardiovasc Interv. 2021;97:E653-E660.
  • 40. Unterberg C, Buchwald AB, Barath P, Schmidt T, Kreuzer H, Wiegand V. Cutting balloon coronary angioplasty -- initial clinical experience. Clin Cardiol. 1993;16:660-664.
  • 41. Barath P, Fishbein MC, Vari S, Forrester JS. Cutting balloon: a novel approach to percutaneous angioplasty. Am J Cardiol. 1991;68:1249-1252.
  • 42. Bonaventura K, Schwefer M, Yusof AKM, et al. Systematic Scoring Balloon Lesion Preparation for Drug-Coated Balloon Angioplasty in Clinical Routine: Results of the PASSWORD Observational Study. Adv Ther. 2020;37:2210-2223.
  • 43. Okura H, Hayase M, Shimodozono S, et al. Mechanisms of acute lumen gain following cutting balloon angioplasty in calcified and noncalcified lesions: an intravascular ultrasound study. Catheter Cardiovasc Interv. 2002;57:429-436.
  • 44. Barbato E, Shlofmitz E, Milkas A, Shlofmitz R, Azzalini L, Colombo A. State of the art: evolving concepts in the treatment of heavily calcified and undilatable coronary stenoses - from debulking to plaque modification, a 40-year-long journey. EuroIntervention. 2017;13:696-705.
  • 45. de Ribamar Costa JJ, Mintz GS, Carlier SG, et al. Nonrandomized comparison of coronary stenting under intravascular ultrasound guidance of direct stenting without predilation versus conventional predilation with a semi-compliant balloon versus predilation with a new scoring balloon. Am J Cardiol. 2007;100:812-817.
  • 46. Felekos I, Karamasis GV, Pavlidis AN. When everything else fails: High-pressure balloon for undilatable lesions. Cardiovasc Revasc Med. 2018;19:306-313.
  • 47. Díaz JF, Gómez-Menchero A, Cardenal R, Sánchez-González C, Sanghvi A. Extremely high-pressure dilation with a new noncompliant balloon. Tex Heart Inst J. 2012;39:635-638.
  • 48. Secco GG, Ghione M, Mattesini A, et al. Very high-pressure dilatation for undilatable coronary lesions: indications and results with a new dedicated balloon. EuroIntervention. 2016;12:359-365.
  • 49. Secco GG, Buettner A, Parisi R, et al. Clinical Experience with Very High-Pressure Dilatation for Resistant Coronary Lesions. Cardiovasc Revasc Med. 2019;20:1083-1087.
  • 50. Rheude T, Rai H, Richardt G, et al. Super high-pressure balloon versus scoring balloon to prepare severely calcified coronary lesions: the ISAR-CALC randomised trial. EuroIntervention. 2021;17:481-488.
  • 51. Delgado-Arana JR, Rumoroso JR, Regueiro A, et al. Plaque modification in calcified chronic total occlusions: the PLACCTON study. Rev Esp Cardiol. 2022;75:213-222.
  • 52. Vilalta del Olmo V, Rodríguez-Leor O, Redondo A, et al. Intracoronary lithotripsy in a high-risk real-world population. First experience in severely calcified, complex coronary lesions. REC Interv Cardiol. 2020;2:76-81.
  • 53. Hill JM, Kereiakes DJ, Shlofmitz RA, et al. Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Artery Disease. J Am Coll Cardiol. 2020;76:2635-2646.
  • 54. Kereiakes DJ, Hill JM, Shlofmitz RA, et al. Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Lesions: 1-Year Results From the Disrupt CAD III Study. J Soc Cardiovasc Angiogr Interv. 2022. https://doi.org/10.1016/j.jscai.2021.100001.
  • 55. Ali ZA, Nef H, Escaned J, et al. Safety and Effectiveness of Coronary Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Stenoses: The Disrupt CAD II Study. Circ Cardiovasc Interv. 2019;12:e008434.
  • 56. Pham V, Bonnet M, Varenne O, et al. In-stent use of Intravascular Coronary Lithotripsy for restenosis and stent underexpansion, a multicenter experience. Can J Cardiol. 2022;10:1474-1475.
  • 57. Achim A, Alampi C, Krivoshei L, Leibundgut G. In vitro effect of intravascular lithotripsy on the polymer of a drug-eluting stent. EuroIntervention. 2022;18:e333-e334.
  • 58. Tovar Forero MN, Sardella G, Salvi N, et al. Coronary lithotripsy for the treatment of underexpanded stents; the international & multicentre CRUNCH registry. EuroIntervention. 2022;18:574-581.
  • 59. Gonzálvez-García A, Jiménez-Valero S, Galeote G, Moreno R, López de Sá E, Jurado-Román A. “RotaTripsy”: Combination of Rotational Atherectomy and Intravascular Lithotripsy in Heavily Calcified Coronary Lesions: A Case Series. Cardiovasc Revasc Med. 2022;35:179-184.
  • 60. Yarusi BB, Jagadeesan VS, Hussain S, et al. Combined Coronary Orbital Atherectomy and Intravascular Lithotripsy for the Treatment of Severely Calcified Coronary Stenoses: The First Case Series. J Invasive Cardiol. 2022;34:E210-E217.
  • 61. Jurado-Román A, García A, Moreno R. ELCA-Tripsy: Combination of Laser and Lithotripsy for Severely Calcified Lesions. J Invasive Cardiol. 2021;33:E754-E755.
  • 62. Amemiya K, Yamamoto MH, Maehara A, et al. Effect of cutting balloon after rotational atherectomy in severely calcified coronary artery lesions as assessed by optical coherence tomography. Catheter Cardiovasc Interv. 2019;94:936-944.
  • 63. Jurado-Román A, Gonzálvez A, Galeote G, Jiménez-Valero S, Moreno R. RotaTripsy: Combination of Rotational Atherectomy and Intravascular Lithotripsy for the Treatment of Severely Calcified Lesions. JACC Cardiovasc Interv. 2019;12:e127-e129.
  • 64. Chen G, Zrenner B, Pyxaras SA. Combined Rotational Atherectomy and Intravascular Lithotripsy for the Treatment of Severely Calcified in-Stent Neoatherosclerosis: A Mini-Review. Cardiovasc Revasc Med. 2019;20:819-821.
  • 65. Protty MB, Gallagher S, Farooq V, et al. Combined use of rotational and excimer lASER coronary atherectomy (RASER) during complex coronary angioplasty - An analysis of cases (2006-2016) from the British Cardiovascular Intervention Society database. Catheter Cardiovasc Interv. 2021;97:E911-E918.
  • 66. McInerney A, Escaned J, Gonzalo N. Calcified coronary artery disease: pathophysiology, intracoronary imaging assessment, and plaque modification techniques. REC Interv Cardiol. 2022;4:216-227.
  • 67. Bulluck H, McEntegart M. Contemporary tools and devices for coronary calcium modification. JRSM Cardiovasc Dis. 2022. https://doi.org/10.1177/20480040221089760.
  • 68. Ambrosini V, Sorropago G, Laurenzano E, et al. Early outcome of high energy Laser (Excimer) facilitated coronary angioplasty ON hARD and complex calcified and balloOn-resistant coronary lesions: LEONARDO Study. Cardiovasc Revasc Med. 2015;16:141-146.
  • 69. Karacsonyi J, Armstrong EJ, Truong HTD, et al. Contemporary Use of Laser During Percutaneous Coronary Interventions: Insights from the Laser Veterans Affairs (LAVA) Multicenter Registry. J Invasive Cardiol. 2018;30:195-201.
  • 70. Yamamoto MH, Maehara A, Kim SS, et al. Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography. Catheter Cardiovasc Interv. 2019;93:1211-1218.
Fonte de datos: Dialnet