Key result
Serial IVL enables successful calcium fracture and optimal stent expansion in severely calcified coronary stenosis.
Why the study?
Percutaneous coronary intervention of severely calcified coronary artery stenosis is associated with stent underexpansion and adverse outcomes, and the effect of serial intravascular lithotripsy cycles on calcium fractures and stent expansion is not well described.
Does serial intravascular lithotripsy improve calcium fracture and stent expansion in a severely calcified, undilatable coronary artery stenosis?
Case Report (n=1)
Does serial intravascular lithotripsy improve calcium fracture and stent expansion in a severely calcified, undilatable coronary artery stenosis?
Serial cycles of intravascular lithotripsy, guided by intravascular ultrasound, can induce multiple calcium fractures and optimize stent expansion in severely calcified and undilatable coronary lesions.
May aid stent expansion in undilatable calcified stenoses; hypothesis-generating pending controlled trials.
Percutaneous coronary intervention of a severely calcified coronary artery stenosis is associated with stent underexpansion and adverse outcomes. Intravascular lithotripsy (IVL) is a novel technology for fracturing calcified plaque in the coronary artery. We describe the first case of a severely calcified, undilatable coronary artery lesion. After 2 IVL cycles, the balloon expanded, but only 1 calcium fracture occurred by intravascular ultrasound. After 2 additional IVL cycles, there were multiple calcium fractures, and the stent expanded optimally. We concluded that serial IVL cycles lead to multiple calcium fractures and expand the stent optimally.
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Saleem et al. (2024) conducted a case report in Severely calcified, undilatable coronary artery stenosis (n=1). Intravascular lithotripsy (IVL) was evaluated on Calcium fracture and stent expansion (assessed by IVUS). Serial intravascular lithotripsy cycles (40 pulses) resulted in multiple calcium fractures and optimal stent expansion in a severely calcified, undilatable coronary artery stenosis, with no clinical events at 11 months.
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