title: Indications and outcomes of excimer laser coronary atherectomy: Efficacy and safety for thrombotic lesions-The ULTRAMAN registry.
abstract: Excimer laser coronary atherectomy (ELCA) recently became available in Japan, but ELCA's effectiveness and safety are not clear.
  
  
  
  We enrolled consecutive patients who underwent ELCA and were registered in the Utility of Laser for Transcatheter Atherectomy-Multicenter Analysis around Naniwa (ULTRAMAN) registry comprising six Japanese medical centers around Naniwa in Japan with patients registered from April 2006 to June 2015. We evaluated the catheter sizes used and compared the success rate, thrombolysis in myocardial infarction (TIMI) flow, blush score, and complications between the rich-thrombus (RT) group [acute coronary syndrome (ACS) and saphenous vein graft (SVG)] and the poor-thrombus (PT) group [in-stent restenosis (ISR), chronic total occlusion (CTO), calcification, and long or bifurcation (L&B) lesions]. Of the 328 patients, 6 (1.8%) were treated for an SVG, 175 (53.4%) were treated for ACS, 18 (5.5%) for CTO, 106 (32.4%) for ISR, 8 (2.4%) for calcification, and 15 for L&B lesions (4.6%). A 1.7-mm (concentric)-diameter ELCA catheter was used most frequently (59.4%). High success rates were achieved in both the RT and PT groups, but the TIMI flow grade and blush score were significantly lower and the complications rate was significantly higher in the RT group (n=181).
  
  
  
  In Japan, the major indications for ELCA have been ACS and ISR. ELCA can provide a safe and effective treatment even for RT lesions.
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. Electronic address: mnishino@orh.go.jp.
authors.forename: Masami
authors.initials: M
authors.lastname: Nishino
authors.affiliation: Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Mori
authors.affiliation: Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Hyogo, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Takiuchi
authors.affiliation: Department of Cardiology, Higashi Takarazuka Satoh Hospital, Takarazuka, Hyogo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shishikura
authors.affiliation: Department of Cardiology, Nara Prefecture Western Medical Center, Ikoma, Nara, Japan.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Doi
authors.affiliation: Division of Cardiology, Bellland General Hospital, Sakai, Osaka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kataoka
authors.affiliation: Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ishihara
authors.affiliation: Cardiovascular Center, Kouseikai Takeda Hospital, Kyoto, Kyoto, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Kinoshita
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D017225:Atherectomy, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D054018:Lasers, Excimer / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012042:Registries; D013927:Thrombosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Acute coronary syndrome; Coronary artery disease; Coronary intervention; In-stent restenosis; Laser