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Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention

Anja Øksnes1, Claudia Cosgrove2, Simon Walsh3

  • 1Haukeland University Hospital, Bergen, Norway.

Journal of Interventional Cardiology
|July 9, 2021
PubMed

Insights

Intravascular lithotripsy (IVL) effectively modified calcium in complex chronic total occlusions (CTO) during percutaneous coronary intervention (PCI). While complications occurred, IVL showed promise for challenging CTO cases.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Intravascular lithotripsy (IVL) is established for non-occlusive coronary artery disease (CAD) calcium modification.
  • Limited data exists on IVL use in calcified chronic total occlusions (CTO).

Purpose of the Study:

  • To evaluate the safety and efficacy of IVL during CTO percutaneous coronary intervention (PCI).

Main Methods:

  • International multicenter registry of 55 CTO PCI procedures using IVL.
  • Analysis of procedural success, complications, and clinical outcomes.
  • Mean J-CTO score of 3.1, with IVL used primarily after CTO crossing.

Main Results:

  • Technical and procedural success rates of 96% and 93%, respectively.
  • Six procedural complications (5%), including 3 main vessel perforations.
  • Low rates of procedural myocardial infarction (4%) and major adverse cardiovascular events (4%) at follow-up.

Conclusions:

  • IVL facilitates calcium modification effectively during CTO PCI.
  • Further research is needed to confirm IVL efficacy and safety in CTO, especially with combination therapy.

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