{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:23:55Z","timestamp":1761578635202,"version":"3.41.2"},"reference-count":16,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,10,27]],"date-time":"2018-10-27T00:00:00Z","timestamp":1540598400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Orbital atherectomy (OA) is a known alternative to other atherectomy devices. However, some complex patient demographics (eg, left ventricular ejection fraction &lt;25%) were excluded from the first\u2010in\u2010human trial (ORBIT I) and the pivotal FDA device approval trial (ORBIT II) which evaluated the safety and efficacy of OA in severely calcified de novo coronary lesions. This single\u2010operator cohort study aimed to examine the impact of OA on a real\u2010world complex Veterans Affairs patient subset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis was completed on 40 consecutive patients with severely calcified coronary lesions who underwent OA prior to drug\u2010eluting stent placement at the Atlanta Veterans Affairs Medical Center from January 2015 to June 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Orbital atherectomy plus drug\u2010eluting stent placement was successful in all 40 cases. Chocolate focal force balloon angioplasty was the most commonly used post\u2010atherectomy balloon (<jats:italic>N<\/jats:italic>\u00a0=\u00a034, 85%). Few complications were observed, including one case (2.5%) of perforation and one case (2.5%) of no\u2010reflow. Neither acute stent thrombosis nor emergent coronary artery bypass grafting was observed. The intravascular ultrasound (IVUS)\u2010determined median [IQR] pre\u2010procedure minimum lumen area and post\u2010procedure minimum stent area (MSA) were 2.8 [2.2, 3.0] mm<jats:sup>2<\/jats:sup> and 8.7 [7.7, 10.0] mm<jats:sup>2<\/jats:sup>, respectively (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001, Mann\u2010Whitney test). Major adverse cardiovascular events, including all\u2010cause mortality, at 30\u00a0days and at a median [IQR] follow\u2010up of 197.5 [35.5, 461.3] days, was 5% and 10%, respectively. During that period, one target vessel revascularization (2.5%) was observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study indicates that OA is a useful tool in performing high\u2010risk percutaneous coronary intervention effectively in VA patients with severely calcified coronary lesions. OA plaque modification in combination with a high utilization rate of IVUS and Chocolate focal force angioplasty facilitates stent delivery and optimal stent expansion, resulting in a large MSA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.99","type":"journal-article","created":{"date-parts":[[2018,10,27]],"date-time":"2018-10-27T11:03:39Z","timestamp":1540638219000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Plaque modification of severely calcified coronary lesions via orbital atherectomy: Single\u2010center observations from a complex Veterans Affairs cohort"],"prefix":"10.1002","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5315-6426","authenticated-orcid":false,"given":"Rupak","family":"Desai","sequence":"first","affiliation":[{"name":"Division of Cardiology Emory University and Atlanta Veterans Affairs Medical Center  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omer","family":"Mirza","sequence":"additional","affiliation":[{"name":"Division of Cardiology Emory University and Atlanta Veterans Affairs Medical Center  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5372-7065","authenticated-orcid":false,"given":"Brad J.","family":"Martinsen","sequence":"additional","affiliation":[{"name":"Department of Clinical and Scientific Affairs, Cardiovascular Systems, Inc.  St. Paul MN USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4284-846X","authenticated-orcid":false,"given":"Gautam","family":"Kumar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Emory University and Atlanta Veterans Affairs Medical Center  Atlanta GA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,10,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.7.1959"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.96.1.128"},{"issue":"1","key":"e_1_2_9_4_1","first-page":"28","article-title":"Drug\u2010eluting stents following rotational atherectomy for heavily calcified coronary lesions: long\u2010term clinical outcomes","volume":"23","author":"Benezet J","year":"2011","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.06.064"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22541"},{"issue":"3","key":"e_1_2_9_7_1","first-page":"63","article-title":"Rotational atherectomy to enable sorolimus\u2010eluting stent implantation in calcified, nondilatable de novo coronary artery lesions","volume":"4","author":"Schl\u00fcter M","year":"2007","journal-title":"Vasc Manag"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.01.158"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1586\/17434440.2014.929493"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccl.2015.12.003"},{"volume-title":"Textbook of Atherectomy","year":"2016","author":"Chambers J","key":"e_1_2_9_11_1"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2017.1384695"},{"issue":"3","key":"e_1_2_9_13_1","article-title":"Chocolate CHIP intervention: an orbital experience","volume":"24","author":"Marrero O","year":"2016","journal-title":"Cath Lab Dig"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2016.04.006"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.26000"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2009.10.005"},{"issue":"3","key":"e_1_2_9_17_1","first-page":"285","article-title":"Assessment and quantitation of stent results by intracoronary optical coherence tomography","volume":"4","author":"Maehara A","year":"2015","journal-title":"Interv Cardiol Clin"}],"container-title":["Health Science Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhsr2.99","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hsr2.99","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T01:34:26Z","timestamp":1694741666000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hsr2.99"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,27]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["10.1002\/hsr2.99"],"URL":"https:\/\/doi.org\/10.1002\/hsr2.99","archive":["Portico"],"relation":{},"ISSN":["2398-8835","2398-8835"],"issn-type":[{"type":"print","value":"2398-8835"},{"type":"electronic","value":"2398-8835"}],"subject":[],"published":{"date-parts":[[2018,10,27]]},"assertion":[{"value":"2018-06-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-27","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e99"}}