Key result
Intravascular lithotripsy achieves ~95% procedural success in severely calcified coronary lesions.
Why the study?
Severe coronary artery calcification complicates PCI by causing inadequate lesion preparation, suboptimal stent expansion, and increased procedural complications, and real-world data on intravascular lithotripsy effectiveness and safety are limited.
Does intravascular lithotripsy achieve high procedural success and safety in patients undergoing percutaneous coronary intervention for severely calcified coronary lesions?
Observational (n=110)
No
Does intravascular lithotripsy achieve high procedural success and safety in patients undergoing percutaneous coronary intervention for severely calcified coronary lesions?
In a real-world setting, intravascular lithotripsy is a safe and highly effective strategy for modifying severely calcified coronary lesions, resulting in excellent procedural success rates even among high-risk patients with acute coronary syndrome.
Supports IVL in calcified lesions for PCI; hypothesis-generating and should not change practice without randomized evidence.
Background: Severe coronary artery calcification remains a major challenge during percutaneous coronary intervention (PCI), often resulting in inadequate lesion preparation, suboptimal stent expansion, and increased procedural complications. Intravascular lithotripsy (IVL) has emerged as a novel calcium-modification technique that uses acoustic pressure waves to fracture vascular calcium and facilitate optimal stent deployment. However, real-world data regarding its effectiveness and safety remain limited.Objectives: To evaluate the clinical outcomes, procedural success, and safety of IVL-assisted PCI in patients with severely calcified coronary lesions in a prospective single-center real-world setting.Materials and Methods:This prospective observational study included 110 consecutive patients with severely calcified coronary artery lesions who underwent IVL-assisted PCI at a tertiary care center. Baseline demographic, clinical, angiographic, procedural, and follow-up data were prospectively collected. The primary endpoint was procedural success, defined as successful stent implantation with residual stenosis <30% and final TIMI grade 3 flow without in-hospital major adverse cardiac events (MACE). Secondary endpoints included device success, angiographic success, procedural complications, and 30-day clinical outcomes.Results: The mean age of the study population was 66.4 ± 9.8 years, and 76.4% were male. Hypertension (73.6%), dyslipidemia (61.8%), and diabetes mellitus (49.1%) were the most prevalent cardiovascular risk factors. Acute coronary syndrome was present in 61.8% of patients. The left anterior descending artery was the most frequently treated vessel (47.3%), while multivessel disease was observed in 43.6% of patients. Conclusion:Intravascular lithotripsy is a highly effective and safe calcium-modification strategy for the treatment of severely calcified coronary lesions. The high procedural success rates, low complication rates, and favorable short-term clinical outcomes observed in this study support the routine use of IVL in complex calcified coronary artery disease.
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Rahul et al. (2026) conducted an observational in Severely calcified coronary artery lesions requiring percutaneous coronary intervention (n=110). Intravascular lithotripsy (IVL) was evaluated on Procedural success (successful stent delivery and deployment with residual stenosis <30% and final TIMI grade 3 flow in the absence of in-hospital major adverse cardiac events). Intravascular lithotripsy achieved a high procedural success rate of 94.5% and a low 30-day major adverse cardiac event rate of 6.4% in patients with severely calcified coronary lesions.
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