Intravascular Lithotripsy for Vessel Preparation in Calcified Coronary Arteries Prior to Stent Placement ― Japanese Disrupt CAD IV Study 1-Year Results ―

Q: What is the clinical evidence from this study?

Population: Severe coronary artery calcification (n=64). Intervention: Intravascular lithotripsy (IVL). Primary outcome: Major adverse cardiovascular events (MACE) at 1 year.

Shigeru Saito; Seiji Yamazaki; Akihiko Takahashi; Atsuo Namiki; Tomohiro Kawasaki; Satoru Otsuji; Shigeru Nakamura; Yoshisato Shibata

doi:10.1253/circrep.cr-22-0068

August 19, 2022Circulation ReportsOpen Access

Intravascular Lithotripsy for Vessel Preparation in Calcified Coronary Arteries Prior to Stent Placement ― Japanese Disrupt CAD IV Study 1-Year Results ―

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Why the study?

Disrupt CAD IV showed low 30-day MACE and high procedural success following IVL in severe coronary artery calcification, but long-term outcomes had not been reported.

Does intravascular lithotripsy improve 1-year outcomes in patients with severe coronary artery calcification prior to stent placement?

Structured PICO

Does intravascular lithotripsy improve 1-year outcomes in patients with severe coronary artery calcification prior to stent placement?

P

Population

64 Japanese patients (mean age 75, 25% female) with severely calcified de novo coronary artery lesions undergoing percutaneous coronary intervention, followed for 1 year.

I

Intervention

Intravascular lithotripsy (IVL) for vessel preparation prior to stent placement

O

Outcome

1-year outcomes (including major adverse cardiovascular events)composite

This analysis evaluates the 1-year outcomes of intravascular lithotripsy for severe coronary artery calcification in the Japanese Disrupt CAD IV study.

Limitations

Coronary IVL has not been directly compared to other modalities for vessel preparation, such as atherectomy, in prospective trials.
The adjunctive use of atherectomy in conjunction with coronary IVL was not evaluated.
The number of adverse events identified in this trial was insufficient to identify risk factors using statistical techniques.
Did not evaluate coronary IVL treatment prior to the use of a drug-coated balloon.

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Implication

1-year Japanese cohort data on IVL for severe CAC; leaves open comparative efficacy versus alternatives.

Abstract

Background: Intravascular lithotripsy (IVL) delivers acoustic pressure waves to modify calcium, enhance vessel compliance, and optimize stent deployment. The Disrupt CAD IV study enrolled patients with severe coronary artery calcification and demonstrated low 30-day major adverse cardiovascular events (MACE) and high procedural success following IVL with no final serious angiographic complications. To date, long-term outcomes have not been reported. This analysis evaluates 1-year outcomes of Disrupt CAD IV.

Discussion

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Cite This Study

Saito et al. (2022) studied Severe coronary artery calcification (n=64). Intravascular lithotripsy (IVL) was evaluated on Major adverse cardiovascular events (MACE) at 1 year.

synapsesocial.com/papers/6a9f692406c9dea3e3f3c7b7 https://doi.org/10.1253/circrep.cr-22-0068

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Intravascular Lithotripsy for Vessel Preparation in Calcified Coronary Arteries Prior to Stent Placement ― Japanese Disrupt CAD IV Study 1-Year Results ―

Figures

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Intravascular Lithotripsy for Vessel Preparation in Calcified Coronary Arteries Prior to Stent Placement ― Japanese Disrupt CAD IV Study 1-Year Results ―

Figures

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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