Background: 

Percutaneous coronary intervention of calcified lesions is associated with a higher prevalence of target vessel revascularization and myocardial infarction. Intravascular lithotripsy (IVL) has been recently proposed for the treatment of calcified coronary lesions. However, data regarding the efficacy and safety in comparison to other techniques are lacking.

Methods:

We performed a prospective, propensity score-matched study to compare strategy success in 57 consecutive patients who got IVL guided PCI in calcified coronary lesions with patients who were treated with high-pressure dilatation with non-compliant (nc)- ballon. The 1:3 propensity score-matching resulted in 171 matched pairs. Mean minimal lumen diameter (MLD) for IVL group was 0.91±0.51 mm, median diameter stenosis on quantitative angiography was 70.6% (interquartile range, 53.5–82.0). MLD in high pressure dilatation group was 0.97±0.43 mm, median diameter stenosis was 71.49% (interquartile range, 58.5–77.0). For IVL versus high-pressure nc- balloon dilatation, strategy success was significantly higher (82.46% vs. 61.4%; p: 0.002).IVL- guided PCI reduced stenosis to 17.51% (interquartile range, 6.7–22.5) with an acute gain of 1.84 mm. High- pressure nc- balloon dilatation resulted in a final diameter stenosis 19.29%  (interquartile range, 7.9–28.5). Angiographic complications (coronary dissection, slow or no reflow, new coronary thrombus formation during PCI, abrupt vessel closure) were in both groups very low (0.2% vs. 0.12%)

Conclusion:

IVL resulted in a significantly higher rate of strategy success compared to high- pressure nc- balloon dilatation in patients with calcified coronary lesions.