Debulking in Cardiovascular Interventions and Revascularization Strategies

Book excerpt: Debulking in Cardiovascular Interventions and Revascularization Strategies: Between a Rock and the Heart aims to provide a comprehensive overview on the diagnostic and therapeutic aspects of resistant lesions as well as tailored debulking processes in revascularization strategies. Cardiovascular interventionalists and surgeons alike frequently encounter technical challenges and increased risk when attempting to diagnose and treat resistant cardiovascular lesions, bio-tissues and vessels. Calcified plaques, fibrotic or thrombotic lesions, total occlusions, degenerative plaques, complex lesions and vessels impose morphologic obstacles to the safe and effective delivery and deployment of balloons and stents. In such instances, a debulking strategy involving the actual drilling and extraction of the targeted plaque/bio-tissue constitutes a unique option that ensures safe and efficacious subsequent balloon dilatations and stenting. A range of topics is included in the book, from the characteristics and constituents of various resistant targets and bio-tissues, to the corresponding options of debulking methods, and finally the technologic and pharmacologic means available for application. The book also provides an up-to-date description of related management solutions and tools, exploring the medical issues pertaining to the patients with these targets; procedural results and clinical outcomes as related to debulking strategies and associated diagnostic and therapeutic technology and revascularization options. Review and discussion of the pathophysiology of cardiovascular resistant lesions Analysis of the impact on revascularization outcome of cardiovascular lesions/bio-tissues which exhibit resistance to standard revascularization Introduction of the concept of debulking for revascularization of cardiovascular diseases: comprehensive description Presentation of the clinical scenarios associated with resistant cardiovascular lesions and bio-tissue that require debulking Delineation of various state-of-the -art diagnostic imaging modalities for detection and demonstration of the lesions and tissues that require debulking Presentation of the expansive array of mechanical revascularization tools available for debulking Description of surgical debulking approaches to resistant cardiovascular lesions Summary of debulking outcomes