Title : The efficacy of novel intravascular lithotripsy in the treatment of coronary artery stenosis with calcified lesions: a systematic review
Purpose:High levels of coronary artery stenosis (>50%) increases the risk for ischemic heart disease, the leading cause of death worldwide. A novel procedure called intravascular lithotripsy (IVL) can reduce the levels of coronary artery stenosis by disrupting calcified plaques and improving the success of subsequent stent placement.
Methods:Patients included adults ≥18 years old with stenosis in one or more coronary arteries of greater than 50% with evidence of cardiac ischemia and calcified lesions who were eligible for percutaneous coronary intervention (PCI) and underwent IVL using the Shockwave Medical Coronary IVL System. Data was obtained from four Disrupt CAD studies, comprising 627 total patients. Statistical analysis was conducted using Microsoft Excel.
Results:672 patients were analyzed who underwent an IVL procedure followed by stent placement. 94.5% (593) of patients had procedural success of stent delivery with residual in-stent stenosis of
<50%, and 74.7% (468) of patients with residual stenosis of <30%. 93% (583) of patients did not have any major adverse cardiac events within thirty days post-procedure. Adverse effects included 5.7% (36) cases of myocardial infarction within thirty days post-procedure, and 0.5%
- cases of cardiac death.
Conclusion:IVL is an effective procedure to facilitate stenting in coronary arteries with calcification and occlusion >50%. The procedural success rate based on novel studies is high and there are few adverse complications, suggesting favorable clinical results which may be further explored in future studies.
- The audience will learn about a novel, FDA approved technique to improve outcomes in patients who they may consider for the procedure.
- Knowledge of this novel technique will not only facilitate improvements to clinical care of patients but also further scientific inquiry about methods to treat coronary artery calcification.
- The results of this systematic review highlight the potential for further development of intravascular lithotripsy for the treatment of coronary artery stenosis among attendees.
- The results of this systematic review suggest exploration of the utility of lithotripsy for the treatment of other diseases.