Intravascular Lithotripsy Versus Rotational Atherectomy in Coronary Chronic Total Occlusions: Analysis from the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention Registry.

Autor: Carvalho PEP; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Strepkos D; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Alexandrou M; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Mutlu D; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Ser OS; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Choi JW; Department of Cardiology, Texas Health Presbyterian Hospital, Dallas, Texas., Gorgulu S; Department of Cardiology, Biruni University Medical School, Istanbul, Turkey., Jaffer FA; Cardiovascular Research Center, Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts., Chandwaney R; Department of Invasive Cardiology, Oklahoma Heart Institute, Tulsa, Oklahoma., Alaswad K; Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan., Basir MB; Department of Cardiology, Henry Ford Cardiovascular Division, Detroit, Michigan., Azzalini L; Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington., Ozdemir R; Department of Cardiology, Bezmiâlem Vakıf University, Istanbul, Turkey., Uluganyan M; Department of Cardiology, Bezmiâlem Vakıf University, Istanbul, Turkey., Khatri J; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Young L; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio., Poommipanit P; Section of Cardiology, Case Western Reserve University, Cleveland, Ohio., Aygul N; Department of Cardiology, Selcuk University, Konya, Turkey., Davies R; Department of Cardiology, WellSpan Health, York, Pennsylvania., Krestyaninov O; Department of Invasive Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russian Federation., Khelimskii D; Department of Invasive Cardiology, Meshalkin Novosibirsk Research Institute, Novosibirsk, Russian Federation., Goktekin O; Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey., Akyel A; Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey., Tuner H; Department of Cardiology, Memorial Bahcelievler Hospital, Istanbul, Turkey., Rafeh NA; Department of Cardiology, North Oaks Health System, Hammond, Louisiana., Elguindy A; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Foundation, Aswan, Egypt., Rangan BV; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Mastrodemos OC; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Voudris K; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Burke MN; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Sandoval Y; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota., Brilakis ES; Center For Coronary Artery Disease, Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, Minneapolis, Minnesota. Electronic address: esbrilakis@gmail.com.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2024 Oct 24; Vol. 235, pp. 37-43. Date of Electronic Publication: 2024 Oct 24.
DOI: 10.1016/j.amjcard.2024.10.018
Abstrakt: There are limited comparative data on the use of plaque modification devices during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We compared intravascular lithotripsy (IVL) with rotational atherectomy (RA) for lesion preparation in patients who underwent CTO PCI across 50 US and non-US centers from 2019 to 2024. Of 15,690 patients who underwent CTO PCI during the study period, 436 (2.78%) underwent IVL and 381 (2.45%) RA. Patients treated with IVL had more co-morbidities and more complex CTO lesions. Antegrade wiring was the most used initial and successful crossing strategy for lesions treated with both IVL and RA, although the retrograde approach was more frequently used in IVL cases. Procedure and fluoroscopy times, and air kerma radiation doses and contrast volumes, were greater in patients treated with RA than those treated with IVL. There were no significant differences between the groups in technical success (97.2% vs 95.3%, p = 0.20), procedural success (94.7% vs 91.8%, p = 0.14), and in-hospital major adverse cardiac events (MACEs) (3.0% vs 4.2%, p = 0.47). However, coronary artery perforations were more frequent in patients who underwent RA (9.5% vs 3.2%, p <0.001). Multivariable logistic regression analysis revealed that IVL compared with RA was not independently associated with technical success, procedural success, or in-hospital MACE. In patients who undergo CTO PCI, IVL is associated with similar in-hospital MACE, technical success, and procedural success but lower incidence of coronary artery perforation compared with RA.
Competing Interests: Declaration of competing interest Dr. Jaffer reports sponsored research for Canon, Siemens, Shockwave, Teleflex, Boston Scientific, HeartFlow, and Neovasc; consultant/speakers fees from Magenta Medical, Philips, Biotronik, Mercator, Terumo (Canon), Abiomed, Shockwave, DurVena, Intravascular Imaging Inc., Medtronic, and FastWave; equity interest in Intravascular Imaging Inc., DurVena, and FastWave; and Massachusetts General Hospital licensing arrangements: Terumo, Canon, and SpectraWAVE, for which Dr. Jaffer has the right to receive royalties. Dr. Azzalini received consulting fees from Teleflex, Abiomed, GE Healthcare (Little Chalfont, United Kingdom), Reflow Medical, Shockwave, and Cardiovascular Systems, Inc.; received a research grant by Abiomed; serves on the advisory board of Abiomed and GE Healthcare; and owns equity in Reflow Medical. Dr. Davies receives speaking honoraria from Abiomed, Asahi Intec, Boston Sci, Medtronic, Shockwave, and Teleflex; and serves on advisory boards for Abiomed, Avinger, Boston Sci, Medtronic, Rampart, and Shockwave. Dr. Sandoval receives consulting/speaker honoraria from Abbott Diagnostics, Roche Diagnostics, Zoll, and Philips; is JACC Advances associate editor; and reports Patent 20,210,401,347. Dr. Brilakis receives consulting/speaker honoraria from Abbott Vascular, American Heart Association (associate editor Circulation), Biotronik, Boston Scientific, Cardiovascular Innovations Foundation (Board of Directors), CSI, Elsevier, GE Healthcare, IMDS, Medtronic, and Teleflex; research support from Boston Scientific, GE Healthcare; is owner, Hippocrates LLC; and is shareholder in MHI Ventures, Cleerly Health, Stallion Medical. The remaining authors have no competing interests to declare.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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