Key result
IVL during primary PCI for STEMI shows feasibility and safety with ~18% 30-day MACE.
Why the study?
The utility and safety of intravascular lithotripsy for coronary calcium modification during primary PCI for STEMI were not well described.
Is intravascular lithotripsy safe and feasible for the treatment of calcific coronary lesions during primary PCI for STEMI?
Observational (n=72)
Yes
Is intravascular lithotripsy safe and feasible for the treatment of calcific coronary lesions during primary PCI for STEMI?
Intravascular lithotripsy appears feasible and safe for modifying calcific coronary lesions during primary PCI for STEMI, achieving good stent expansion with acceptable short-term complication rates.
IVL appears feasible for calcified culprit lesions in STEMI primary PCI; leaves open need for randomized trials to confirm safety and outcomes.
AIMS: To describe the utility and safety of intravascular lithotripsy (IVL) in the setting of primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI). METHODS AND RESULTS: We performed a retrospective analysis, across six UK sites of all patients in whom IVL was used for coronary calcium modification of the culprit lesion during primary PCI for STEMI. The 72 patients were included. IVL was used in de-novo culprit lesions in 57 (79%) of cases and culprit in-stent restenoses in 11 (15%) of cases. In four cases (6%) it was used in a newly deployed stent when this was under-expanded due to inadequate calcium modification. Of the 30 cases in which intracoronary imaging was available for stent analysis, the average stent expansion was 104%. Intra-procedural stent thrombosis occurred in one case (1%), and no-reflow in three cases (4%). The 30 day MACE rates were 18%. CONCLUSION: IVL appears to be feasible and safe for use in the treatment of calcific coronary artery disease in the setting of STEMI.
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Cosgrove et al. (2021) conducted an observational in ST elevation myocardial infarction (STEMI) with calcific coronary lesions (n=72). Intravascular lithotripsy (IVL) was evaluated on 30-day Major Adverse Cardiovascular Events (MACE). Intravascular lithotripsy for calcific coronary lesions during primary PCI for STEMI was feasible and safe, with a 30-day MACE rate of 18% and intra-procedural stent thrombosis in 1% of cases.
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