Download 3.1416 and All That, Second Edition by Philip J. Davis, William G. Chinn PDF

By Philip J. Davis, William G. Chinn

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In-stent restenosis. Access Right or left femoral artery. Anticoagulation Aspirin, clopidogrel, and heparin. Heparin is preferred over bivalirudin in case rapid reversal of anticoagulation is needed in the event of a perforation. Equipment 1. Short 6–8 Fr sheath. 2. 6–8 Fr coronary guide catheter, 100 cm. 3. 014" wire. Procedure 1. Currently available cutting balloons include the AngioSculpt® and the Flextome®. Before the procedure, determine which one will be used and whether a 300-cm wire is required.

The notable difference is that the “burr” for rotational atherectomy spins with a tight axis of rotation that is centered over the wire, while the “crown” for orbital atherectomy spins with an orbital axis so that it conforms to the inner circumference of the vessel wall, even if oblique or eccentric. The result of orbital atherectomy is that a larger effective vessel size can be atherectomized. Rotational atherectomy is used for the coronaries, while orbital atherectomy is well-suited for the vessels of the lower extremities.

Ostial, bifurcation, or nonpassable lesions, which are only mildly calcified. Severe calcification is a contraindication to the use of  t */%*$ "5* 0 / 4 " / %5& $ ) / *2 6 & 4 0 ' 1 & 3$6 5"/ & 0 6 4 1 30 $& % 6 3& 4 this device as the atherotomes can potentially get stuck. Cutting balloon angioplasty may be performed prior to stenting. 2. In-stent restenosis. Access Right or left femoral artery. Anticoagulation Aspirin, clopidogrel, and heparin. Heparin is preferred over bivalirudin in case rapid reversal of anticoagulation is needed in the event of a perforation.

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