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Microcap & Penny Stocks : AMERICAN BIOMED, Minimally Invasive Technology (ABMI) -- Ignore unavailable to you. Want to Upgrade?

To: J.J. who wrote (307)	3/26/1998 9:15:00 AM
From: Aishwarya	Read Replies (2) \| Respond to of 2887

Rotational Atherectomy : A promise in to the future ( ABMI Omnicath Atherectomy Catheter ) Various interventions have been developed to try to improve on the problems that have encountered with angioplasty, the most troubling which is restenosis or a repeated narrowing of the artery after the original balloon angioplasty. The intracoronary stent, which has come along in the past several years, has demonstrated a significant improvement upon angioplasty in certain subsets of patients. The initial stent that came out was only capable of being used under certain circumstances when there were already problems encountered during a case, i.e., an abrupt occlusion. The current generation of stents has been approved by the FDA on an elective basis, and has already greatly proven its worth in terms of perhaps reducing restenosis by 50%. Nevertheless, at this time we still have some restrictions on that can be approached percutaneously, The stent itself, being a metallic device that is delivered on a sheath, is somewhat stiff and difficult to use in certain anatomical situations. In addition, smaller vessels are not shown to be significantly improved in terms of outcomes with stents. An area of intervention called, "Atherectomy", which represents an attempt to address the lesion by actual removal of debris in some fashion or another, has been around for some time. The so called, "Directional Atherectomy" showed very promising results particularly in the hands of those individuals who had developed the procedure. It was however a technically difficult procedure, and again the initial iterations of equipment were rather bulky and somewhat difficult to use except in large arteries with proximal blockages. The so called, "Rotablator" or "Rotational Atherectomy" has come into its own in the past five or six years. Again, it is a somewhat technically demanding procedure but has demonstrated a niche where it does appear to be very useful. It seems to have particular application in arteries that are heavily calcified. Doctors occasionally encounter arteries where it is virtually impossible to open the artery with a balloon because of heavy calcification. In addition, since a balloon cannot open the artery, a stent also will be not ideally expanded and not address the problem well. This is where the rotational device seems to have a great deal of applicability. This device is designed to ablate plaque selectively. It is a high speed rotational diamond tip device that rotates at 11,000 revolutions per minute and is able to selectively ablate plaque, breaking up into particles that are smaller than red blood cells. As long as there is not too much plaque addressed by the device, the procedure is usually well tolerated and can open a pathway that will then permit a balloon angioplasty or a stenting of the artery. Technically there are a number of situations where the rotational atherectomy is not applicable, i.e. inside saphenous vein grafts or when there is a considerable amount of thrombus present. If one is unable to pass a guidewire, the Rotablator cannot be used. Also, if there is a lot of plaque burdening the artery, i.e. greater than 25mm of plaque that has to be addressed, the particular debris represents too much of a burden for the distal circulation and can cause a small non Q wave infarction. Nevertheless, it appears to be applicable and useful in perhaps as many as 15-20% of coronary interventions. This represents just one more area of rapidly advancing innovation in the area of percutaneous treatment of coronary disease. Rotational atherectomy then, combined with angioplasty and/orstenting, shows a great deal of promise in a subgroup of patients where doctors have difficulties addressing blockages with other modalities. It looks particularly promising in some smaller vessels and heavily calcified vessels. Regards, Sri.