Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry.

Autor: Wańha W; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland., Tomaniak M; 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland., Wańczura P; Department of Cardiology, The Ministry of Internal Affairs and Administration Hospital, 35-111 Rzeszów, Poland., Bil J; Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland., Januszek R; Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland., Wolny R; Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland., Opolski MP; Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland., Kuźma Ł; Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland., Janas A; Faculty of Medicine and Health Science, Andrzej Frycz Modrzewski Kraków University, 30-705 Krakow, Poland., Figatowski T; First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland., Gąsior P; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland., Milewski M; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland., Roleder-Dylewska M; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland., Lewicki Ł; Department of Invasive Cardiology, University Center for Cardiology, 80-211 Gdansk, Poland., Kulczycki J; Department of Cardiology, Miedziowe Centrum Zdrowia, 59-300 Lubin, Poland., Włodarczak A; Department of Cardiology, Miedziowe Centrum Zdrowia, 59-300 Lubin, Poland., Tomasiewicz B; Centre for Heart Disease, University Hospital, 50-558 Wroclaw, Poland.; Department of Heart Disease, Wroclaw Medical University, 50-367 Wroclaw, Poland., Iwańczyk S; Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland., Sacha J; Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, 45-040 Opole, Poland., Koltowski Ł; 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland., Dziarmaga M; Department of Cardiology-Intensive Therapy and Internal Diseases, Poznan University of Medical Sciences, 60-355 Poznan, Poland., Jaguszewski M; First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland., Kralisz P; Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland., Olajossy B; 1st Military Hospital in Lublin, 20-049 Lublin, Poland., Sobieszek G; 1st Military Hospital in Lublin, 20-049 Lublin, Poland., Dyrbuś K; Third Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland., Łebek M; Upper Silesia Medical Centre, 40-635 Katowice, Poland., Smolka G; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland., Reczuch K; Centre for Heart Disease, University Hospital, 50-558 Wroclaw, Poland.; Department of Heart Disease, Wroclaw Medical University, 50-367 Wroclaw, Poland., Gil RJ; Department of Invasive Cardiology, Centre of Postgraduate Medical Education, 02-507 Warsaw, Poland., Dobrzycki S; Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland., Kwiatkowski P; Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland., Rogala M; Terumo, 02-134 Warszawa, Poland., Gąsior M; Third Department of Cardiology, Medical University of Silesia, 40-055 Katowice, Poland., Ochała A; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland., Kochman J; 1st Department of Cardiology, Medical University of Warsaw, 02-091 Warszawa, Poland., Witkowski A; Department of Interventional Cardiology and Angiology, National Institute of Cardiology, 04-628 Warsaw, Poland., Lesiak M; Department of Cardiology, Poznan University of Medical Sciences, 61-701 Poznan, Poland., D'Ascenzo F; Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, 10124 Turin, Italy., Bartuś S; Department of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland., Wojakowski W; Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Mar 23; Vol. 11 (7). Date of Electronic Publication: 2022 Mar 23.
DOI: 10.3390/jcm11071779
Abstrakt: Background: Whereas the efficacy and safety of intravascular lithotripsy (IVL) have been confirmed in de novo calcified coronary lesions, little is known about its utility in treating stent underexpansion. This study aimed to investigate the impact of IVL in treating stent underexpansion. Methods and Results: Consecutive patients with stent underexpansion treated with IVL entered the multicenter IVL-Dragon Registry. The procedural success (primary efficacy endpoint) was defined as a relative stent expansion >80%. Thirty days device-oriented composite endpoint (DOCE) (defined as a composite of cardiac death, target lesion revascularization, or target vessel myocardial infarction) was the secondary endpoint. A total of 62 patients were enrolled. The primary efficacy endpoint was achieved in 72.6% of patients. Both stent underexpansion 58.5% (47.5−69.7) vs. 11.4% (5.8−20.7), p < 0.001, and the stenotic area 82.6% (72.4−90.8) vs. 21.5% (11.1−37.2), p < 0.001, measured by quantitative coronary angiography improved significantly after IVL. Intravascular imaging confirmed increased stent expansion following IVL from 37.5% (16.0−66.0) to 86.0% (69.2−90.7), p < 0.001, by optical coherence tomography and from 57.0% (31.5−77.2) to 89.0% (85.0−92.0), p = 0.002, by intravascular ultrasound. Secondary endpoint occurred in one (1.6%) patient caused by cardiac death. There was no target lesion revascularization or target vessel myocardial infarction during the 30-day follow-up. Conclusions: In this real-life, largest-to-date analysis of IVL use to manage underexpanded stent, IVL proved to be an effective and safe method for facilitating stent expansion and increasing luminal gain.
Databáze: MEDLINE
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