Critical Limb Ischemia Clinical Trial
Official title:
Diamondback Atherectomy With OCT Visualization for Calcified PAD Lesions for Calcified Peripheral Vascular Disease Lesions
This is a prospective, nonrandomized, single-arm study using CSI Orbital Atherectomy System in patients with PAD (total occlusions or significant stenosis). Patients will be enrolled if they have claudication and/or critical limb ischemia, and identifiable PAD disease with moderate to severe calcification on Computer Tomography Angiogram (PCA) or peripheral angiogram requiring percutaneous peripheral intervention (PPI).
Orbital atherectomy (OA) is one of the most commonly used modalities for the treatment of
obstructive femoral-popliteal PAD, especially in patients with large and calcified
atherosclerotic plaques, either as stand alone or with subsequent drug-coated balloon
angioplasty or stent implantation. These atherectomy procedures were primarily guided by
peripheral angiography which has significant resolution limitations in regards to the plaque
morphology and characteristics such as extent of calcification, and how deep the cuts are
made in the vessel wall.
Optical coherence tomography (OCT) has recently emerged as a novel imaging modality. OCT
imaging has been used both in coronary as well as in peripheral circulation extensively with
no significant device related adverse effects. Previous research has shown the feasibility
and safety of OCT use for peripheral artery imaging and its use in plaque characterization.
The hypothesis for this study is that; use of diamond back atherectomy device will lead to
effective removal of plaque in moderate to heavily calcified arteries without damaging deep
into the adventitia or EEL or the adjacent healthy vessel wall and thus will lead to a
favorable vascular response during follow up.
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