1. Safety and effectiveness of coronary intravascular lithotripsy in eccentric calcified coronary lesions: a patient-level pooled analysis from the Disrupt CAD I and CAD II Studies.
- Author
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Blachutzik F, Honton B, Escaned J, Hill JM, Werner N, Banning AP, Lansky AJ, Schlattner S, De Bruyne B, Di Mario C, Dörr O, Hamm C, and Nef HM
- Subjects
- Aged, Coronary Angiography, Coronary Stenosis diagnosis, Coronary Stenosis etiology, Female, Follow-Up Studies, Humans, Male, Prospective Studies, Treatment Outcome, Vascular Calcification complications, Vascular Calcification diagnosis, Coronary Stenosis therapy, Coronary Vessels diagnostic imaging, Endovascular Procedures methods, Lithotripsy methods, Stents, Vascular Calcification surgery
- Abstract
Background: The aim of this study was to assess the safety and effectiveness of intravascular lithotripsy (IVL) in treating eccentric calcified coronary lesions., Methods: Between December 2015 and March 2019, 180 patients were enrolled in the Disrupt CAD I and CAD II studies across 19 sites in 10 countries. Patient-level data were pooled from these two studies (n = 180), within which 47 eccentric lesions (26%) and 133 concentric lesions were identified., Results: Clinical success, defined as residual stenosis < 50% after stenting and no in-hospital MACE, was similar between the eccentric and concentric cohorts (93.6% vs. 93.2%, p = 1.0). There were no perforations, abrupt closure, slow flow or no reflow events observed in either group, and there were low rates of flow-limiting dissections (Grade D-F: 0% eccentric, 1.7% concentric; p = 0.54). Final acute gain and percent residual stenosis were similar between the two groups. Final residual stenosis of 8.6 ± 9.8% in eccentric and 10.0 ± 9.0% (p = 0.56) in concentric stenosis confirms the significant effect of IVL in calcified coronary lesions., Conclusion: In this first report from a pooled patient-level analysis of coronary IVL from the Disrupt CAD I and CAD II studies, IVL use was associated with consistent improvement in procedural and clinical outcomes in both eccentric and concentric calcified lesions.
- Published
- 2021
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