Related Experiment Video

Updated: Sep 14, 2025

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension

Published on: June 6, 2025

339

Procedural and Clinical Outcomes of Coronary Intravascular Lithotripsy in Patients With Impaired Renal Function: A

Akshay A S Phagu1, Martijn J H van Oort1, Federico Oliveri1

  • 1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.

The American Journal of Cardiology
|July 24, 2025
PubMed

Insights

Intravascular lithotripsy (IVL)-assisted percutaneous coronary intervention (PCI) shows similar procedural and major adverse cardiovascular event (MACE) rates in patients with and without renal insufficiency. However, chronic kidney disease is associated with higher mortality post-IVL PCI.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Chronic kidney disease (CKD) is common in patients undergoing percutaneous coronary intervention (PCI).
  • The impact of renal insufficiency on outcomes after intravascular lithotripsy (IVL)-assisted PCI is not well understood.
  • This study investigates IVL-assisted PCI outcomes in patients with varying degrees of renal function.

Purpose of the Study:

  • To evaluate procedural and long-term outcomes of IVL-assisted PCI in patients with renal insufficiency compared to those with normal renal function.
  • To identify predictors of mortality in patients undergoing IVL-assisted PCI.

Main Methods:

  • Retrospective analysis of 558 patients from the BENELUX-IVL registry (May 2019-September 2024).
  • Renal insufficiency defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m².
  • Primary endpoint: major adverse cardiovascular events (MACE) at one and two years. Secondary endpoints: procedural success, all-cause mortality.

Main Results:

  • No significant difference in one-year MACE (13.3% vs. 10.9%, p=0.80) or two-year MACE (5.6% vs. 2.8%, p=0.46) between groups.
  • Procedural success rates were similar (88.6% vs. 88.7%, p=0.97).
  • All-cause mortality was significantly higher in patients with renal insufficiency (18.2% vs. 11.5%, p=0.03).
  • Lower eGFR was an independent predictor of mortality (OR 0.98; 95% CI 0.97-1.00; p=0.020).

Conclusions:

  • IVL-assisted PCI demonstrates comparable procedural success and MACE rates irrespective of renal function.
  • Patients with renal insufficiency undergoing IVL-assisted PCI face a significantly higher risk of all-cause mortality.
  • Renal function, specifically eGFR, is a critical factor influencing long-term survival after IVL-assisted PCI.

Keywords:
all-cause mortalitychronic kidney disease (CKD)intravascular lithotripsy (IVL)major adverse cardiovascular events (MACE)percutaneous coronary intervention (PCI)renal insufficiency

More Related Videos

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser07:17

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser

Published on: May 9, 2018

8.1K
Use of a Hanging-weight System for Isolated Renal Artery Occlusion07:54

Use of a Hanging-weight System for Isolated Renal Artery Occlusion

Published on: July 19, 2011

16.1K

Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
29
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
57
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
161
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
24
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
45
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
76