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Intravascular imaging-guided intracoronary lithotripsy: First real-world experience

Hannah Sinclair1,2, Lampson Fan1, Eoin Fahy3

  • 1Cardiothoracic Centre, Freeman Hospital Newcastle upon Tyne Hospitals NHS Foundation Trust Newcastle upon Tyne UK.

Health Science Reports
|August 17, 2021
PubMed

Insights

Intravascular lithotripsy (IVL) effectively modifies calcified coronary lesions, demonstrating safety and high procedural success in real-world use. This technique is particularly beneficial when guided by intracoronary imaging for optimal calcium treatment.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Coronary calcification poses a significant challenge in interventional cardiology.
  • Intravascular lithotripsy (IVL) offers a novel approach to treat complex calcified lesions.

Purpose of the Study:

  • To evaluate the real-world application and outcomes of IVL in patients with calcified coronary lesions.
  • To assess the safety, deliverability, and effectiveness of IVL in diverse clinical settings.

Main Methods:

  • A retrospective analysis of 65 patients treated with IVL between June 2018 and November 2019.
  • Data collected included technical and procedural success, complications, and 30-day clinical outcomes.
  • Intracoronary imaging was utilized in 68% of cases.

Main Results:

  • High procedural success rate (98.5%) with successful balloon delivery in all cases.
  • Significant improvement in Minimum Lumen Area (MLA) post-percutaneous coronary intervention (PCI) by 261.9%.
  • Low incidence of procedural complications (two cases) and favorable 30-day outcomes with one death and one repeat procedure.

Conclusions:

  • Intravascular lithotripsy is a deliverable, safe, and effective modality for calcium modification in complex coronary lesions.
  • The use of intracoronary imaging enhances the effectiveness of IVL in real-world scenarios.
  • This study represents the largest series of imaging-guided IVL for calcified lesions to date.
Abstract

Keywords:
coronary artery diseaselithotripsyoptical coherence tomographypercutaneous coronary intervention

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