Transluminal extraction coronary atherectomy

B. H. Annex, M. H. Sketch, R. S. Stack, H. R. Phillips

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The TEC is a forward-cutting atherectomy catheter that has the unique potential to excise and aspirate atheroma, especially intraluminal thrombus. This device has been under clinical investigation for more than 6 years and received final marketing approval by the FDA for the treatment of lesions in the coronary vasculature in 1993. In the US TEC Multicenter Registry, the overall clinical and lesion successes were favorable. The success rates were similar for both native coronary vessels and saphenous vein bypass grafts. Importantly, the procedural success rates were maintained even in the presence of several unfavorable angiographic features, such as ostial location, intraluminal thrombus, and total occlusion. Further insights into the mechanisms of action of the TEC were made from studies using percutaneous angioscopy and intravascular ultrasound. Angioscopy clearly demonstrated that the TEC was indeed able to remove intraluminal thrombus, especially loosely adherent red thrombus, in a population of patients with unstable coronary syndromes. However, the TEC frequently leaves behind multiple intimal disruptions which not only create a possible nidus for restenosis but also explain the frequent hazy angiographic appearance of the vessel after TEC atherectomy. As is true for all new interventional devices, the specific niche for the TEC in interventional cardiology will best be determined in randomized clinical trials. There are several areas in which the TEC appears promising. First, this device may have a role in the management of patients with diffusely diseased saphenous vein grafts. Second, the TEC may be an effective primary therapy in lesions with intraluminal thrombus. Treatment with the TEC may then be followed by an adjunctive therapy to maximize the final vessel diameters. Finally, the TEC may be valuable in the treatment of lesions in patients with high-risk unstable coronary syndromes.

Original languageEnglish
Pages (from-to)611-622
Number of pages12
JournalCardiology Clinics
Volume12
Issue number4
StatePublished - Jan 1 1994
Externally publishedYes

Fingerprint

Coronary Atherectomy
Thrombosis
Angioscopy
Atherectomy
Saphenous Vein
Equipment and Supplies
Coronary Vessels
Tunica Intima
Transplants
Therapeutics
Atherosclerotic Plaques
Marketing
Cardiology
Registries
Catheters
Randomized Controlled Trials
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Annex, B. H., Sketch, M. H., Stack, R. S., & Phillips, H. R. (1994). Transluminal extraction coronary atherectomy. Cardiology Clinics, 12(4), 611-622.

Transluminal extraction coronary atherectomy. / Annex, B. H.; Sketch, M. H.; Stack, R. S.; Phillips, H. R.

In: Cardiology Clinics, Vol. 12, No. 4, 01.01.1994, p. 611-622.

Research output: Contribution to journalArticle

Annex, BH, Sketch, MH, Stack, RS & Phillips, HR 1994, 'Transluminal extraction coronary atherectomy', Cardiology Clinics, vol. 12, no. 4, pp. 611-622.
Annex BH, Sketch MH, Stack RS, Phillips HR. Transluminal extraction coronary atherectomy. Cardiology Clinics. 1994 Jan 1;12(4):611-622.
Annex, B. H. ; Sketch, M. H. ; Stack, R. S. ; Phillips, H. R. / Transluminal extraction coronary atherectomy. In: Cardiology Clinics. 1994 ; Vol. 12, No. 4. pp. 611-622.
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