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. 2023 Dec:57:18-24.
doi: 10.1016/j.carrev.2023.06.027. Epub 2023 Jun 28.

Treatment effect of medial arterial calcification in below-knee after Auryon laser atherectomy using micro-CT and histologic evaluation

John Rundback  1 , Kenji Kawai  2 , Yu Sato  2 , Marianne Brodmann  3 , Peter Schneider  4 , Michele B Corbet  5 , Rika Kawakami  2 , Takao Konishi  2 , Saikat Kumar B Ghosh  2 , Renu Virmani  2 , Aloke V Finn  6
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Free article

Treatment effect of medial arterial calcification in below-knee after Auryon laser atherectomy using micro-CT and histologic evaluation

John Rundback et al. Cardiovasc Revasc Med. 2023 Dec.
Free article

Abstract

Purpose: To determine the frequency of medial arterial calcification (MAC) fracture following Auryon laser atherectomy using micro-CT and histologic evaluation in an atherosclerotic human cadaveric limb model.

Methods: Two below-the-knee calcified arterial segments from human cadaver limbs underwent treatment with the Auryon laser system with or without plain old balloon angioplasty (POBA). Micro-CT and angiography were performed before and after treatment followed by histological evaluation of regions showing calcium disruption.

Results: All treatment zones were successfully treated with the Auryon laser (n = 9). Six of 9 treatment zones showed calcium fracture on micro-CT. Each treatment zone was further subdivided using micro-CT analysis (36 evaluated sections) of which 18 sections revealed calcium fracture. Sections with calcium fracture had significantly more confluent and uninterrupted circumferential calcification than sections without calcium fracture (arc of calcification 360.0 [323.7-360.0] vs 312.8 [247.4-314.2] degree, p = 0.007), whereas there were no differences in size of calcium burden (3.4 [2.8-3.9] vs 2.8 [1.3-4.6] mm2, p = 0.46). No arterial dissection or rupture was seen.

Conclusions: Auryon laser atherectomy produced fractures of medial arterial calcification in this cadaveric human atherosclerotic peripheral artery model. This effect was observed in arterial segments with a pattern of circumferential uninterrupted calcification (i.e. larger arc of calcification) regardless of calcium burden. Our pilot data suggests Auryon laser may be a promising therapy for calcified lesions.

Keywords: Atherosclerosis; Calcification; Histology; Laser atherectomy; micro-computed tomography.

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Conflict of interest statement

Declaration of competing interest This study was funded by AngioDynamics, Inc, Latham, NY, USA. CVPath Institute, Inc., Gaithersburg, MD, USA, provided full support for this work. JR is consultant for Abbot, AngioDynamics, BD BARD, Boston Scientific, CSI, CLI Global Society, Cordis, Inari Medical, Inc., Jansen Pharmaceutical, Medtronic Philips. JR has received honoraria from Abbot, AngioDynamics, BD BARD, Boston Scientific, CSI,GORE, Jansen Pharmaceutical, Medtronic Philips. PS is consultant for Medtronic, Boston Scientific, Philips, Cagent, LimFlow, Silk Road, Surmodics. CVPath Institute has received institutional research support from R01 HL141425, RECOVER Initiative (OT2HL161847-01), NIH RECOVER480 (OT2HL161847-01, PATHO-PH1-SUB _04_22), Biomedical; 4C Medical, 4Tech, Abbott Vascular, Ablative Solutions, Absorption Systems, Advanced NanoTherapies, Aerwave Medical, Alivas, Amgen, Asahi Medical, Aurios Medical, Avantec Vascular, BD, Biosensors, Biotronik, Biotyx Medical, Bolt Medical, Boston Scientific, Canon, Cardiac Implants, Cardiawave, CardioMech, Cardionomic, Celonova, Cerus EndoVascular, Chansu Vascular Technologies, Children's National, Concept Medical, Cook Medical, Cooper Health, Cormaze, CRL, Croivalve, CSI, Dexcom, Edwards Lifesciences, Elucid Bioimaging, eLum Technologies, Emboline, Endotronix, Envision, Filterlex, Imperative Care, Innovalve, Innovative, Cardiovascular Solutions, Intact Vascular, Interface Biolgics, Intershunt Technologies, Invatin, Lahav, Limflow, L&J Bio, Lutonix, Lyra Therapeutics, Mayo Clinic, Maywell, MDS, MedAlliance, Medanex, Medtronic, Mercator, Microport, Microvention, Neovasc, Nephronyx, Nova Vascular, Nyra Medical, Occultech, Olympus, Ohio Health, OrbusNeich, Ossiso, Phenox, Pi-Cardia, Polares Medical, Polyvascular, Profusa, ProKidney, LLC, Protembis, Pulse Biosciences, Qool Therapeutics, Recombinetics, Recor Medical, Regencor, Renata Medical, Restore Medical, Ripple Therapeutics, Rush University, Sanofi, Shockwave, SMT, SoundPipe, Spartan Micro, Spectrawave, Surmodics, Terumo Corporation, The Jacobs Institute, Transmural Systems, Transverse Medical, TruLeaf, UCSF, UPMC, Vascudyne, Vesper, Vetex Medical, Whiteswell, WL Gore, and Xeltis. AVF has received honoraria from Abbott Vascular; Biosensors; Boston Scientific; Celonova; Cook Medical; CSI; Lutonix Bard; Sinomed; Terumo Corporation; and is a consultant to Amgen; Abbott Vascular; Boston Scientific; Celonova; Cook Medical; Lutonix Bard; Sinomed. RV has received honoraria from Abbott Vascular; Biosensors; Boston Scientific; Celonova; Cook Medical; Cordis; CSI; Lutonix Bard; Medtronic; OrbusNeich Medical; CeloNova; SINO Medical Technology; ReCor Medical; Terumo Corporation; W. L. Gore; Spectranetics; and is a consultant for Celonova; Cook Medical; CSI; Edwards Lifesciences; Bard BD; Medtronic; OrbusNeich Medical; ReCor Medical; SinoMedical Sciences Technology; Surmodics; Terumo Corporation; W. L. Gore; Xeltis. MC is an employee of AngioDynamics. The other authors have no competing interests.

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