Clinical Outcomes of Percutaneous Coronary Intervention Using Excimer Laser Coronary Atherectomy for Complex Coronary Lesions: The ACCELERATE Registry
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2025
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| author | Salvatore Davide Tomasello Carla Rochira Alessandro Mazzapicchi Marco Legnazzi Salvatore Adriano Azzarelli Alessandro Di Giorgio Francesco Scardaci Sergio Monaco Vincenzo Argentino Silvia Motta Giorgio Sacchetta Giombattista Barrano Giovanni Ruscica Andrea Sole Paolo Mazzone Francesco Saia Francesco Amico Marco Contarini |
| author_facet | Salvatore Davide Tomasello Carla Rochira Alessandro Mazzapicchi Marco Legnazzi Salvatore Adriano Azzarelli Alessandro Di Giorgio Francesco Scardaci Sergio Monaco Vincenzo Argentino Silvia Motta Giorgio Sacchetta Giombattista Barrano Giovanni Ruscica Andrea Sole Paolo Mazzone Francesco Saia Francesco Amico Marco Contarini Salvatore Davide Tomasello Carla Rochira Alessandro Mazzapicchi Marco Legnazzi Salvatore Adriano Azzarelli Alessandro Di Giorgio Francesco Scardaci Sergio Monaco Vincenzo Argentino Silvia Motta Giorgio Sacchetta Giombattista Barrano Giovanni Ruscica Andrea Sole Paolo Mazzone Francesco Saia Francesco Amico Marco Contarini |
| collection | Wiley Open Access |
| contents | Clinical Outcomes of Percutaneous Coronary Intervention Using Excimer Laser Coronary Atherectomy for Complex Coronary Lesions: The ACCELERATE Registry Salvatore Davide Tomasello Carla Rochira Alessandro Mazzapicchi Marco Legnazzi Salvatore Adriano Azzarelli Alessandro Di Giorgio Francesco Scardaci Sergio Monaco Vincenzo Argentino Silvia Motta Giorgio Sacchetta Giombattista Barrano Giovanni Ruscica Andrea Sole Paolo Mazzone Francesco Saia Francesco Amico Marco Contarini Catheterization and Cardiovascular Interventions ABSTRACT Background Excimer laser coronary atherectomy (ELCA) is a technology used to treat a wide spectrum of complex coronary lesions, such as thrombotic lesions, severe calcific lesions, non‐crossable or non‐expandable lesions, chronic total occlusions, stent under‐expansion, and stent restenosis. Aims and Methods This prospective multicenter observational study aims at examining procedural, in‐hospital and long‐term clinical outcomes in a consecutive cohort of patients treated with ELCA for complex coronary lesions. The primary end point was the rate of procedural success, defined as PCI success plus the absence of in‐hospital MACE. Results From July 2018 to May 2024 a total of 320 consecutive patients (age 71 ± 9 years) with 429 lesions treated with ELCA were enrolled. The most common clinical presentation was chronic coronary syndrome (48%), and the left anterior descending artery was the target vessel in 47% of cases. The subsets of lesions treated were stent restenosis (48%), de novo lesions (46%), and stent underexpansion (6%). Procedural success was achieved in 97% of patients. In‐hospital MACE occurred in 1.2% of cases, mainly driven by death (0.9%) and no reflow (0.9%). After multivariate analysis, left ventricular function was recognized as independent predictor of procedural failure (OR 0.9, 95% CI 0.84−0.97, p = 0.006). During a median clinical follow‐up of 841 days (interquartile range: 395−1414) the survival free from MACE was 94.7%. Death was 2.9%, MI 1.5%, TLR 3.4%, and the composite was 4.7%. Conclusion ELCA demonstrates a high rate of angiographic and clinical success in treating complex coronary lesions in a real‐world cohort of high‐risk patients. 10.1002/ccd.31739 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1002/ccd.31739 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_ccd_31739 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Clinical Outcomes of Percutaneous Coronary Intervention Using Excimer Laser Coronary Atherectomy for Complex Coronary Lesions: The ACCELERATE Registry Salvatore Davide Tomasello Carla Rochira Alessandro Mazzapicchi Marco Legnazzi Salvatore Adriano Azzarelli Alessandro Di Giorgio Francesco Scardaci Sergio Monaco Vincenzo Argentino Silvia Motta Giorgio Sacchetta Giombattista Barrano Giovanni Ruscica Andrea Sole Paolo Mazzone Francesco Saia Francesco Amico Marco Contarini Catheterization and Cardiovascular Interventions Clinical Outcomes of Percutaneous Coronary Intervention Using Excimer Laser Coronary Atherectomy for Complex Coronary Lesions: The ACCELERATE Registry Salvatore Davide Tomasello Carla Rochira Alessandro Mazzapicchi Marco Legnazzi Salvatore Adriano Azzarelli Alessandro Di Giorgio Francesco Scardaci Sergio Monaco Vincenzo Argentino Silvia Motta Giorgio Sacchetta Giombattista Barrano Giovanni Ruscica Andrea Sole Paolo Mazzone Francesco Saia Francesco Amico Marco Contarini Catheterization and Cardiovascular Interventions ABSTRACT Background Excimer laser coronary atherectomy (ELCA) is a technology used to treat a wide spectrum of complex coronary lesions, such as thrombotic lesions, severe calcific lesions, non‐crossable or non‐expandable lesions, chronic total occlusions, stent under‐expansion, and stent restenosis. Aims and Methods This prospective multicenter observational study aims at examining procedural, in‐hospital and long‐term clinical outcomes in a consecutive cohort of patients treated with ELCA for complex coronary lesions. The primary end point was the rate of procedural success, defined as PCI success plus the absence of in‐hospital MACE. Results From July 2018 to May 2024 a total of 320 consecutive patients (age 71 ± 9 years) with 429 lesions treated with ELCA were enrolled. The most common clinical presentation was chronic coronary syndrome (48%), and the left anterior descending artery was the target vessel in 47% of cases. The subsets of lesions treated were stent restenosis (48%), de novo lesions (46%), and stent underexpansion (6%). Procedural success was achieved in 97% of patients. In‐hospital MACE occurred in 1.2% of cases, mainly driven by death (0.9%) and no reflow (0.9%). After multivariate analysis, left ventricular function was recognized as independent predictor of procedural failure (OR 0.9, 95% CI 0.84−0.97, p = 0.006). During a median clinical follow‐up of 841 days (interquartile range: 395−1414) the survival free from MACE was 94.7%. Death was 2.9%, MI 1.5%, TLR 3.4%, and the composite was 4.7%. Conclusion ELCA demonstrates a high rate of angiographic and clinical success in treating complex coronary lesions in a real‐world cohort of high‐risk patients. 10.1002/ccd.31739 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Clinical Outcomes of Percutaneous Coronary Intervention Using Excimer Laser Coronary Atherectomy for Complex Coronary Lesions: The ACCELERATE Registry |
| topic | Catheterization and Cardiovascular Interventions |
| url | https://onlinelibrary.wiley.com/doi/10.1002/ccd.31739 |