5 mm and ≤ 4.0 mm by angiogram; 4) main target vessel classified as Thrombolysis and Myocardial Infarction Selleck C59 wnt (TIMI) grade 3 flow and 5) lesion length ≤ 25 mm. Patients were excluded if there was evidence of an acute myocardial infarction (MI) within 72 hours prior to the intended treatment or previous percutaneous coronary intervention (PCI) or surgery on any vessel within 30 days prior to the intended intervention. Additionally, only one lesion could

be treated during the index procedure. If the patient had two lesions, the patient was staged and the non-target lesion was treated first. Per study protocol, the creatine kinase-myocardial band (CK-MB) levels were required to be within laboratory normal ranges at least 12 hours after non-target lesion treatment and within 8 hours prior to treating the target lesion. The Diamondback 360º® Coronary Orbital Atherectomy System (Cardiovascular Systems, Inc., St. Paul, MN) has been successfully used to treat calcified peripheral vascular stenosis

since 2007. The system has been adapted for use in coronary arteries. The OAS is a percutaneous, endovascular system that incorporates the use of centrifugal force and differential sanding to modify calcified lesions. The OAS utilizes an eccentrically mounted, diamond-coated crown (Fig. 1) that orbits over an atherectomy guide wire at high speeds. Position of the crown within the vessel RO4929097 solubility dmso is controlled via a control handle (Fig. 2). As treatment proceeds, a thin layer of plaque is removed with each pass of the crown. This allows the crown to “sand” away the calcified lesion while the more elastic DNA ligase tissue flexes away from the crown to increase lumen size and modify plaque compliance, depending on the rotational speed chosen. The crown’s orbital diameter expands radially via centrifugal force. The orbital atherectomy procedure removes the calcified stenotic lesion material to increase vessel compliance prior to balloon angioplasty and stent placement, which

may lead to reduced acute vascular injury. Overall, 50 patients were enrolled in the ORBIT I multi-center study. One of the participating centers (Care Institute of Medical Sciences (CIMS), Ahmedabad, India) enrolled and followed 33 of these 50 ORBIT I patients were followed up at Care Institute of Medical Sciences (CIMS), Ahmedabad, India. Ethics committee approval was received and Good Clinical Practice (GCP) guidelines were followed for the conduct of the study. Patients who met the inclusion/exclusion criteria and gave written informed consent were enrolled. All procedures were performed electively. Patients underwent percutaneous coronary treatment in the standard fashion.