The Current Status of Lithoplasty in Vascular Calcifications: A Systematic Review

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Devices

Background:

• Lithoplasty utilizes localized high-speed pressure waves to disrupt vascular calcification.
• Vessel stenosis, particularly due to calcium, poses significant cardiovascular challenges.
• Early outcomes of lithoplasty require systematic review for peripheral and coronary artery disease.

Purpose of the Study:

• To systematically review and summarize the early outcomes of lithoplasty.
• To assess the efficacy of lithoplasty in treating peripheral and coronary artery disease.
• To evaluate the safety and effectiveness of lithoplasty for vascular calcification.

Main Methods:

• Systematic literature search of EMBASE, MEDLINE, and Cochrane Central Register.
• Inclusion of original studies detailing lithoplasty use from database inception to July 2018.
• Duplicate study selection and data extraction with a third author for discrepancy resolution.

Main Results:

• Nine records analyzed, involving 211 patients (average age 73.2 years, follow-up 5.5 months).
• Most lesions (72%) were in peripheral arteries; 62.6% had severe calcium burden and 76.6% initial stenosis.
• Post-lithoplasty residual stenosis averaged 21.0%, with 2.4% requiring stenting due to dissection.

Conclusions:

• Lithoplasty demonstrates promise in decreasing vessel stenosis in both peripheral and coronary artery disease.
• The intervention is associated with a minimal occurrence of major adverse events.
• Further research with rigorous study designs is necessary to confirm lithoplasty's effectiveness in vascular calcifications.