Heavily calcified coronary lesions present a significant challenge in percutaneous coronary intervention (PCI), often leading to complications such as stent underexpansion and malposition, which can negatively impact clinical outcomes. This retrospective study assesses the effectiveness of intravascular lithotripsy (IVL) in preparing calcified coronary lesions before stenting in native coronary lesions and in patients with in-stent restenosis (ISR). Data were collected from patients treated at King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, between January 2019 and January 2025. Patients with coronary lesions exhibiting ≥70% stenosis requiring IVL were included. The primary objectives of the study are to assess key clinical outcomes, including repeat revascularization, target lesion revascularization, stroke, and major adverse cardiovascular events (MACE) post-IVL. Given the increasing use of novel lesion preparation techniques, this study aims to clarify whether IVL in native coronary or ISR offers effective and safe outcomes, potentially influencing treatment decisions for patients with severely calcified coronary lesions. In our study, IVL was demonstrated to be a safe and effective modality for the management of heavily calcified coronary lesions. Among the 45 enrolled patients, successful reperfusion was achieved in all cases, with 100% (45/45) attaining final thrombolysis in myocardial infarction (TIMI) 3 flow. No in-hospital MACE (0%) was reported.
Al-Ebrahim et al. (Wed,) studied this question.
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