{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:20:45Z","timestamp":1790367645758,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,10,7]],"date-time":"2013-10-07T00:00:00Z","timestamp":1381104000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of CONFIRM registry series was to evaluate the use of orbital atherectomy (OA) in peripheral lesions of the lower extremities, as well as optimize the technique of OA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Methods of treating calcified arteries (historically a strong predictor of treatment failure) have improved significantly over the past decade and now include minimally invasive endovascular treatments, such as OA with unique versatility in modifying calcific lesions above and below\u2010the\u2010knee.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients (3135) undergoing OA by more than 350 physicians at over 200 US institutions were enrolled on an \u201call\u2010comers\u201d basis, resulting in registries that provided site\u2010reported patient demographics, ABI, Rutherford classification, co\u2010morbidities, lesion characteristics, plaque morphology, device usage parameters, and procedural outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Treatment with OA reduced pre\u2010procedural stenosis from an average of 88\u201335%. Final residual stenosis after adjunctive treatments, typically low\u2010pressure percutaneous transluminal angioplasty (PTA), averaged 10%. Plaque removal was most effective for severely calcified lesions and least effective for soft plaque. Shorter spin times and smaller crown sizes significantly lowered procedural complications which included slow flow (4.4%), embolism (2.2%), and spasm (6.3%), emphasizing the importance of treatment regimens that focus on plaque modification over maximizing luminal gain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The OA technique optimization, which resulted in a change of device usage across the CONFIRM registry series, corresponded to a lower incidence of adverse events irrespective of calcium burden or co\u2010morbidities. \u00a9 2013 The Authors. Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25046","type":"journal-article","created":{"date-parts":[[2013,6,4]],"date-time":"2013-06-04T13:27:20Z","timestamp":1370352440000},"page":"115-122","source":"Crossref","is-referenced-by-count":65,"title":["Technique optimization of orbital atherectomy in calcified peripheral lesions of the lower extremities"],"prefix":"10.1002","volume":"83","author":[{"given":"Tony","family":"Das","sequence":"first","affiliation":[{"name":"Cardiology and Interventional Vascular Associates Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihad","family":"Mustapha","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Metro Health Hospital Wyoming Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Indes","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of Vascular Surgery Yale University School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Vorhies","sequence":"additional","affiliation":[{"name":"Cox Health Springfield Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Beasley","sequence":"additional","affiliation":[{"name":"Mount Sinai Medical Center Miami Beach Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilesh","family":"Doshi","sequence":"additional","affiliation":[{"name":"South Jersey Radiology Associates Blackwood New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George L.","family":"Adams","sequence":"additional","affiliation":[{"name":"Cardiovascular and Peripheral Vascular Research, Rex Healthcare University of North Carolina Health Systems Raleigh North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.09.024"},{"key":"e_1_2_7_3_1","first-page":"e2","article-title":"Heart disease and stroke statistics--2012 update: a report from the American Heart Association","volume":"125","author":"Roger VL","year":"2012","journal-title":"Circulation"},{"key":"e_1_2_7_4_1","first-page":"26;517","article-title":"Recommended standards for reports dealing with lower extremity ischemia: Revised version","author":"Rutherford RB","year":"1997","journal-title":"J Vasc Surg"},{"key":"e_1_2_7_5_1","first-page":"47;1239","article-title":"ACC\/AHA 2005 guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): executive summary a collaborative report from the American Association for Vascular Surgery\/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC\/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease) endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter\u2010Society Consensus; and Vascular Disease Foundation","author":"Hirsch AT","year":"2006","journal-title":"J Am Coll Cardiol"},{"key":"e_1_2_7_6_1","first-page":"15;117","article-title":"Angiography underestimates peripheral atherosclerosis: Lumenography revisited","author":"Kashyap VS","year":"2008","journal-title":"J Endovasc Ther"},{"key":"e_1_2_7_7_1","first-page":"86;64","article-title":"Contribution of localized calcium deposits to dissection after angioplasty. 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