Key result
Intravascular lithotripsy did not cause serious intimal hyperplasia compared to POBA, but shock waves caused unique damage to the vascular media and adventitia in healthy porcine coronary arteries.
Why the study?
Intravascular lithotripsy is a novel clinical technique for modifying heavily calcified plaques, but the vascular response required investigation in a healthy porcine coronary artery model.
Does intravascular lithotripsy cause vascular damage compared to plain old balloon angioplasty in a healthy porcine coronary model?
Does intravascular lithotripsy cause vascular damage compared to plain old balloon angioplasty in a healthy porcine coronary model?
Answers are grounded in this paper and cite their sources.
In a healthy porcine model, IVL did not cause serious intimal hyperplasia compared to POBA, but resulted in unique damage to the vascular media and adventitia.
OBJECTIVES: In this study, we aimed to investigate the vascular response to an intravascular lithotripsy (IVL) shockwave balloon in a healthy porcine coronary artery model. BACKGROUND: IVL is a novel clinical technique for modifying heavily calcified atherosclerotic plaques. METHODS: A total of 24 porcine coronary arteries were treated with IVL or plain old balloon angioplasty (POBA). Histology, histomorphometry, quantitative coronary angiography analysis (QCA), and optical coherence tomography (OCT) were performed postprocedure and at 1-month follow-up (1M-FU). RESULTS: There was no significant difference in the late lumen loss and diameter stenosis (determined by QCA) and the minimal lumen area (evaluated by OCT) of the IVL and POBA groups at 1M-FU. Pathological analysis revealed that the lumen and neointima areas were similar between the two groups. However, the medial and adventitial layers were more prominent in the IVL than in the POBA group. The injury score and inflammation of the media and adventitia increased dramatically in the IVL group postprocedure and at 1M-FU. At 1M-FU, media fibrin deposition and adventitial fibrosis were also significantly increased in the IVL group. However, there was no significant difference in neointima fibrin deposition, endothelialization, and thrombosis between both groups. Layered separation of the media and adventitia was observed in the IVL group. CONCLUSION: The findings indicate that the IVL balloon did not cause serious intimal hyperplasia and endothelial damage compared with the effects of POBA in the healthy coronary artery. However, shock waves may cause unique damage to the vascular media and adventitia in the coronary artery, which was not observed in the peripheral artery.
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Yin et al. (2023) studied Healthy porcine coronary artery model (n=24). Intravascular lithotripsy (IVL) shockwave balloon vs. Plain old balloon angioplasty (POBA) was evaluated on Vascular response (late lumen loss, diameter stenosis, minimal lumen area, and histology). Intravascular lithotripsy did not cause serious intimal hyperplasia compared to POBA, but shock waves caused unique damage to the vascular media and adventitia in healthy porcine coronary arteries.
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