D-47 | Intravascular Lithotripsy in the Treatment of Coronary Artery Calcification in Patients with Complex High-Risk Indicated Percutaneous Coronary Intervention (CHIP)

The presence of coronary arterial calcification increases procedural complexity and is associated with a higher risk for major adverse cardiac events. Complex high-risk and indicated percutaneous coronary interventions is a rapidly growing field that has gained interest among interventional cardiologists in recent years. The recently introduced IVL lithotripsy appears promising and relatively safer than conventional approaches when dealing with calcified lesions. We enrolled all patients treated with IVL between November 2021 and March 2023 at one Mexican center. Procedural success and complications were assessed and short- and long-term clinical outcomes which included. Thirty patients with a mean age of 71+-8.5 years were treated using IVL.The average syntax score was 32.6+-11.3. Upfront use of IVL occurred in 36% of cases, while bail-out procedures occurred in 40%. Intracoronary imaging was used 83.3% (n = 25). CHIP patients with score > 3 was present in 82.2%. Device success was achieved in 100% of cases. There were no complications related to the IVL balloon (0%). The media number of days of follow-up was 327 +- 119 days. MACE rates following IVL in group of patients with CHIP score >5 (n=10) was 0% and in this group Imaging-Guided Complex PCI accounted for 90% (n=9). CHIP-PCI cases are an increasingly large population in contemporary PCI practice. We show that coronary IVL is a safe and effective adjunctive therapy for treating heavily calcified coronary lesions and CHIP score >5 patients have a high rate of in-hospital events but a low MACE frequency at follow-up, highlighting 90% used Imaging-Guided Complex PCI.