Abstract 1176 Two-year clinical outcome of intravascular lithotripsy in underexpanded stents. A single- center experience

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Two-year clinical outcome of intravascular lithotripsy in underexpanded stents. A single- center experience
A. Aksoy¹, M. Al Zaidi¹, V. Tiyerili², F. Jansen¹, G. Nickenig¹, S. Zimmer¹
¹Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Bonn; ²Klinik für Innere Medizin I, St.-Johannes-Hospital Dortmund, Dortmund;
Background: Stent underexpansion in calcified coronary lesion is associated with a higher prevalence of target vessel revascularization, myocardial infarction, and cardiac death. IVL has been recently proposed for the treatment of stent underexpansion. However, its efficacy, safety and long-term for treatment of stent underexpansion in calcified coronary lesions is unknown. This study sought to assess long-term outcome, efficacy, safety and of intravascular lithotripsy (IVL) in under-expanded stents in calcified coronary lesions. Methods and results: A total of 26 patients with underexpanded stents in calcified lesions treated with IVL were included in this study. Primary endpoint was occurrence of adverse cardiac events (MACE) defined as the composite of death, myocardial infarction, and target vessel revascularization (TVR). Secondary endpoint was procedural success and safety. Procedural success was defined as stent expansion with attainment of <20% in-stent residual stenosis of the target lesion. Safety outcome were procedural complication, defined as coronary dissection, slow or no reflow, new coronary thrombus formation during PCI, abrupt vessel closure and device failure (inability to place the balloon, malfunction, or burst) and in hospital MACE Minimal stent lumen diameter in calcified lesion was 0.57±0.27 mm at baseline and increased to 2.77±0.57 mm after PCI. Average stenosis diameter was 89.40 ± 8.47 % at baseline and decreased to 24.33 ± 18.93 %. Strategy success was achieved in 15 of 26 patient (57.7 %). There was no procedural complication. After 24 months in 9 of 26 patient (34.6 %) occurred myocardial infarction. 7 of 26 patients (26.9 %) showed TLR. 2 patient (7.7 %) died. Conclusions: IVL is safe for treatment of stent underexpansion in calcified coronary lesions. Despite high rates of initial strategy success, MACE within 24 months follow-up was high. Larger studies are warranted before the use of the IVL can be generally recommended.
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