Procedural and clinical impact of intracoronary lithotripsy in heavily calcified aorto‐ostial coronary lesions

Federico Oliveri; Maura Meijer; Martijn J. H. Van Oort; Ibtihal Al Amri; Brian O. Bingen; Bimmer E. Claessen; Aukelien C. Dimitriu‐Leen; Joelle Kefer; Hany Girgis; Tessel Vossenberg; Frank Van Der Kley; J. Wouter Jukema; Jose M. Montero‐Cabezas

doi:10.1002/ccd.31233

journal article Open Access Sep 23, 2024

Procedural and clinical impact of intracoronary lithotripsy in heavily calcified aorto‐ostial coronary lesions

Federico Oliveri

Maura Meijer Martijn J. H. Van Oort

Ibtihal Al Amri Brian O. Bingen

Bimmer E. Claessen

Aukelien C. Dimitriu‐Leen Joelle Kefer Hany Girgis Tessel Vossenberg Frank Van Der Kley

J. Wouter Jukema

Jose M. Montero‐Cabezas

Catheterization and Cardiovascular Interventions Vol. 104 No. 5 pp. 881-890 · Wiley

View at Publisher Save 10.1002/ccd.31233

Abstract

AbstractBackgroundPercutaneous coronary intervention of calcified aorto‐ostial lesions (AOL) pose unique challenges due to anatomical propensity for recoil, leading to poorer outcomes compared to non‐AOL. Although intravascular lithotripsy (IVL) has shown excellent success and safety in heavily calcified plaques, evidence specific to AOL is limited. This study aims to evaluate the efficacy and safety of IVL in AOL versus non‐AOL.MethodsPatients treated with IVL between 2019 and 2023 from an ongoing prospective multicenter registry were eligible for inclusion. Patients were therefore classified in AOL and non‐AOL groups, based on anatomical location. The primary technical endpoint was device success, defined as the ability to deliver the IVL catheter and pulses at the target lesion, without angiographic complications. Secondary technical endpoint encompassed procedural success <30%, consisting of device success with residual stenosis <30%, final thrombolysis in myocardial infarction grade 3 flow, and no in‐hospital major adverse cardiovascular events (MACE). The primary clinical endpoint was in‐hospital MACE, including cardiac death, nonfatal myocardial infarction, or target lesion revascularization.ResultsA total of 321 patients underwent IVL, including 48 with AOL. Device success showed no significant difference between AOL and non‐AOL groups (100% vs. 98.2%; p = 0.35). A nonsignificant trend toward worse procedural success with residual stenosis <30% was observed in the AOL arm (AOL 81.3% vs. non‐AOL 90.5%, p = 0.06). In‐hospital MACE was significantly higher in AOL (4.2% vs. 0.7%, p = 0.048), attributed entirely to cardiac deaths. At 6‐month follow‐up, the incidence of MACE (AOL 8.3% vs. non‐AOL 4.0%, p = 0.19), and cardiac deaths (AOL 4.2% vs non‐AOL1.1%, p = 0.11) were comparable between groups.ConclusionIVL treatment for heavily calcified AOL demonstrates comparable procedural and 6‐month clinical outcomes when compared to non‐AOL, despite a higher incidence of in‐hospital MACE.

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Details

Published: Sep 23, 2024
Vol/Issue: 104(5)
Pages: 881-890
License: View

Authors

F

Federico Oliveri

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

M

Maura Meijer

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

M

Martijn J. H. Van Oort

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

I

Ibtihal Al Amri

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

B

Brian O. Bingen

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

B

Bimmer E. Claessen

Department of Cardiology Amsterdam University Medical Center Amsterdam The Netherlands

A

Aukelien C. Dimitriu‐Leen

Department of Cardiology Radboud University Medical Center Nijmegen The Netherlands

J

Joelle Kefer

Department of Cardiology Saint‐Luc Bruxelles Belgium

H

Hany Girgis

Department of Cardiology Jeroen Bosch Ziekenhuis, Den‐Bosch s‐Hertogenbosch The Netherlands

T

Tessel Vossenberg

Department of Cardiology Medisch Centrum Leeuwarden The Netherlands

F

Frank Van Der Kley

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

J

J. Wouter Jukema

Department of Cardiology Leiden University Medical Center Leiden The Netherlands; Netherlands Heart Institute Utrecht The Netherlands

J

Jose M. Montero‐Cabezas

Department of Cardiology Leiden University Medical Center Leiden The Netherlands

Cite This Article

Federico Oliveri, Maura Meijer, Martijn J. H. Van Oort, et al. (2024). Procedural and clinical impact of intracoronary lithotripsy in heavily calcified aorto‐ostial coronary lesions. Catheterization and Cardiovascular Interventions, 104(5), 881-890. https://doi.org/10.1002/ccd.31233

Procedural and clinical impact of intracoronary lithotripsy in heavily calcified aorto‐ostial coronary lesions

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