Procedural and clinical impact of intravascular lithotripsy for the treatment of peri-stent calcification

Use of intravascular lithotripsy (IVL) for treating peri-stent calcification is increasing. However, this indication remains ‘off-label’. We aimed to investigate the efficacy and clinical outcomes of in-stent IVL. Patients from five European centers who underwent in-stent IVL were included between 2...

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Published in:Cardiovascular revascularization medicine 2024-04, Vol.61, p.16-23
Main Authors: van Oort, Martijn J.H., Al Amri, Ibtihal, Bingen, Brian O., Cordoba-Soriano, Juan G., Karalis, Ioannis, Sanz-Sanchez, Jorge, Oliveri, Federico, van der Kley, Frank, Jukema, J. Wouter, Jurado-Roman, Alfonso, Montero-Cabezas, Jose M.
Format: Article
Language:English
Subjects:
Calcific coronary artery disease
Calcinosis
Constriction, Pathologic
Humans
In-stent
Lithotripsy
Lithotripsy - adverse effects
Percutaneous Coronary Intervention
Stents
Treatment Outcome
Vascular Calcification - diagnostic imaging
Vascular Calcification - therapy
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Summary:Use of intravascular lithotripsy (IVL) for treating peri-stent calcification is increasing. However, this indication remains ‘off-label’. We aimed to investigate the efficacy and clinical outcomes of in-stent IVL. Patients from five European centers who underwent in-stent IVL were included between 2019 and 2023. Demographic, clinical, procedural and follow-up data were collected from electronic hospital records. Angiographic and intracoronary imaging (ICI) data were analyzed in a centralized core-laboratory. Of 101 patients (71.2 ± 9.2 years), 56(55 %) received in-stent IVL for late stent failure (median 109 days post-PCI) due to calcific neoatherosclerosis or extra-stent calcification(late-IVL), while 45(45 %) underwent bail-out IVL due to stent infraexpasion (immediate-IVL). Both late-IVL and immediate-IVL significantly improved angiographic %diameter stenosis (73.7[59.6–89.8]% to 16.4 [10.4–26.9]%;p 
ISSN:1553-8389
1878-0938
DOI:10.1016/j.carrev.2023.10.013