Intravascular lithotripsy in heavily calcified chronic total occlusion: procedural and one-year clinical outcomes

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions Pub Date : 2024-08-29 DOI:10.1002/ccd.31207

Federico Oliveri MD, Martijn J. H. van Oort MSc, Ibtihal Al Amri MD, PhD, Brian O. Bingen MD, PhD, Bimmer E. Claessen MD, PhD, Aukelien C. Dimitriu-Leen MD, PhD, Joelle Kefer MD, PhD, Hany Girgis MD, Tessel Vossenberg MD, PhD, Frank van der MD, PhD, J. Wouter Jukema MD, PhD, Jose M. Montero-Cabezas MD, PhD

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引用次数: 0

Abstract

Background

Calcification within chronic total occlusions (CTO) is strongly associated with worse outcomes. Despite the excellent success and safety of intravascular lithotripsy (IVL) in heavily calcified lesions, evidence in CTO remains scarce.

Aim

This study aimed to evaluate the procedural and long-term clinical outcomes of IVL in heavily calcified CTO.

Methods

Patients who underwent IVL between 2019 and 2024 from an ongoing prospective multicenter registry were eligible for inclusion. Patients were therefore classified in CTO and non-CTO groups. The efficacy and safety endpoints of CTO percutaneous coronary interventions were defined according to the CTO-ARC consensus. In-hospital major adverse cardiovascular events (MACE) included cardiac death, nonfatal myocardial infarction and target lesion revascularization (TVR).

Results

A total of 404 patients underwent IVL, of which the treated lesion was a CTO in 33 (8.2%). The mean J-CTO score was 2.3 ± 1.1. Device success showed no significant difference between CTO and non-CTO groups (100% vs 98.4%; p = 0.35). Comparable technical success with residual stenosis <30% was observed in both groups (90.1% in CTO vs 89.2% in non-CTO, p = 0.83). The incidence of MACE was similar across groups during hospital stays (CTO 6.0% vs. non-CTO 1.9%, p = 0.12), at 30-day (CTO 9.1% vs. non-CTO 3.0%, p = 0.07), and at 12-month follow-up (CTO 9.1% vs. non-CTO 7.3%, p = 0.70).

Conclusion

IVL provides high procedural success and consistent clinical outcomes in both CTO and non-CTO cases, reinforcing its role in managing heavily calcified coronary lesions.

Abstract Image

查看原文本刊更多论文

重度钙化慢性全闭塞的血管内碎石术：手术和一年的临床疗效。

背景：慢性全闭塞（CTO）内的钙化与较差的预后密切相关。尽管血管内碎石术（IVL）在重度钙化病变中取得了卓越的成功和安全性，但在 CTO 中的证据仍然很少：在2019年至2024年期间接受IVL治疗的患者符合纳入条件，这些患者来自一个正在进行的前瞻性多中心登记处。因此，患者被分为CTO组和非CTO组。CTO经皮冠状动脉介入治疗的疗效和安全性终点根据CTO-ARC共识进行定义。院内主要不良心血管事件（MACE）包括心源性死亡、非致死性心肌梗死和靶病变血运重建（TVR）：共有404名患者接受了IVL，其中33人（8.2%）的治疗病变为CTO。平均 J-CTO 评分为 2.3 ± 1.1。CTO组和非CTO组的设备成功率无明显差异（100% vs 98.4%; p = 0.35）。残余狭窄的技术成功率相当结论：IVL在CTO和非CTO病例中均可获得较高的手术成功率和一致的临床效果，从而加强了其在治疗严重钙化冠状动脉病变中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.