1440_Brodmann.pdf

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1、Does IVL Replace AtherectomyDevices in the Calcified SFA Disease?Marianne Brodmann,MDDivision of Angiology,Medical University Graz,AustriaVessel preparation:why needed Successful endovascular therapy of infrainguinal lesions requires 3 steps Lesion crossing Vessel preparation Delivery of definitive

2、therapy Vessel preparation improves the outcomes of all endovascular interventions The advent of drug-coated balloons(DCBs)has led to a re-emphasis on the importance of vessel preparation and plaque modification as a determinant of short-and long-term outcomes,especially for the treatment of complex

3、 lesions A focus on vessel preparation ensures maximal lumen expansion,lower rates of dissection,and may also improve the ability for paclitaxel to penetrate the lesion,thereby resulting in a more robust anti-restenotic effectArmstrong E,et al.Endovasc Today.2017.Goals of Vessel Preparation Broadly,

4、the goal of vessel preparation is to achieve optimal angioplasty,which is typically defined as 30%residual stenosis and absence of any significant flow-limiting dissection(Table 1)Additional factors that may contribute to optimal angioplasty include improved vessel compliance and minimal vessel reco

5、il Armstrong E,et al.Endovasc Today.2017.Calcium:The Barrier Significant barrier to adequate vessel preparation Intravascular ultrasound studies have demonstrated that localized deposits of calcium are associated with dissection location and severity after balloon angioplasty Even after adequate ves

6、sel dilation,the presence of severe calcification may limit drug deliveryFitzgerald PJ.Circulation.1992;86:64-70.Fanelli F,et al.Cardiovasc Intervent Radiol.2014;37:898-907Impact of a Less Than 50%Residual Stenosis Following Vessel Preparation 268 patients(308 limbs)who underwent successful FP inter