Mid-Term Angiographic and Intracoronary Imaging Results Following Intracoronary Lithotripsy in Calcified Coronary Artery Disease: Results From Two Tertiary Referral Centres.

Autor: McInerney A; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Travieso A; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Cubero H; Departamento de Cardiología Intervencionista, Hospital del Mar, IMIM, Universidad Autónoma, Barcelona, Spain., Jerónimo-Baza A; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Jimenez-Quevedo P; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Tirado-Conte G; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Nombela-Franco L; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Macaya-Ten F; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Salinas P; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Rentería HM; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Nuñez-Gil I; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Fernandez-Ortiz A; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Vaquerizo B; Departamento de Cardiología Intervencionista, Hospital del Mar, IMIM, Universidad Autónoma, Barcelona, Spain., Macaya C; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Escaned J; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain., Gonzalo N; Departamento de Cardiología Intervencionista, Hospital Universitario Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain. Electronic address: nieves_gonzalo@yahoo.es.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2023 Jul; Vol. 52, pp. 59-66. Date of Electronic Publication: 2023 Feb 24.
DOI: 10.1016/j.carrev.2023.02.016
Abstrakt: Background: Intracoronary lithotripsy (IVL) is a safe and effective treatment for coronary calcification. Angiographic and intracoronary imaging follow-up have not yet been described. We aimed to describe the mid-term angiographic outcomes following IVL.
Methods: Patients successfully treated with IVL in two tertiary referral hospitals were included. Repeat angiography and intracoronary imaging was performed. Quantitative coronary angiography (QCA) and optical coherence tomography (OCT) analyses were performed using dedicated workstations.
Results: Twenty patients were included; mean age 67.1 years, left anterior descending artery 55 %. Median IVL balloon size was 3.0 mm and a median of 60 pulses were delivered per vessel. Percentage stenosis by QCA was 60 % [IQR 51-70] reducing to 20 % post stenting (p < 0.001). On OCT, 88.9 % had circumferential calcium. IVL resulted in fractures in 88.9 %. Resulting minimum stent expansion was 91.75 % [IQR 81.5-108]. Follow-up was at a median of 22.7 months [IQR16.4-25.5]. Percentage stenosis by QCA was 22.5 % [IQR 14-30] and not significantly different from the index procedure (p > 0.05). Minimum stent expansion by OCT was 85 % [IQR 72-97]. Late luminal loss was 0.15 mm [IQR -0.25 to 0.69]. Binary angiographic instent restenosis (ISR) was 10 % (2 of 20 patients). OCT demonstrated a predominantly homogenous neointimal pattern with high backscatter.
Conclusion: Following successful IVL treatment, repeat angiography demonstrated preserved stent parameters in the majority of patients with favorable vascular healing properties by OCT. A binary restenosis rate of 10 % was observed. These results suggest durable results following IVL treatment of severe coronary calcification however larger studies are warranted.
Competing Interests: Declaration of competing interest Nieves Gonzalo reports a relationship with Abbott that includes: consulting or advisory and speaking and lecture fees. Nieves Gonzalo reports a relationship with Boston Scientific Corp that includes: consulting or advisory and speaking and lecture fees. Nieves Gonzalo reports a relationship with Philips Healthcare that includes: consulting or advisory and speaking and lecture fees. Nieves Gonzalo reports a relationship with Shockwave Medical Inc. that includes: consulting or advisory and speaking and lecture fees. Nieves Gonzalo reports a relationship with AbioMed Inc. that includes: consulting or advisory and speaking and lecture fees. Angela McInerney has received speaker fees from Shockwave medical Inc.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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