Coronary disease & ACSResearch article

Deep Learning-Based Assessment of Coronary Artery Morphologies for Predicting Responsiveness to Intravascular Lithotripsy

JACC AdvPublished

  • Deep learning-based assessment
  • artificial intelligence-enhanced image analysis
  • optical coherence tomography before intravascular lithotripsy (IVL) and after stent deployment
  • linear regression

Authors' conclusion

A deep learning-based approach enhances the predictability of IVL effectiveness in luminal expansion by capturing preprocedural morphological complexities beyond conventional dimensions, supporting personalized procedural planning. Further prospective validation is warranted to confirm its generalizability and clinical impact.

Study context

Population
Patients with varying degrees of coronary artery calcification treated with intravascular lithotripsy (IVL)
Participants
134 patients
Comparison
Prediction performance for poststenting luminal expansion incorporating comprehensive morphological features vs conventional geometric dimensions

Main finding

As reported in the abstract

Prediction performance for luminal expansion following IVL, frame level
Groupadjusted R2root mean square error
Comprehensive morphological features0.717 ± 0.0080.095 ± 0.004
Conventional geometric dimensions0.581 ± 0.0160.133 ± 0.007

Further findings

OutcomeComprehensive morphological featuresConventional geometric dimensions
Prediction performance for luminal expansion following IVL, lesion level
adjusted R20.721 ± 0.0100.582 ± 0.018
root mean square error0.093 ± 0.0090.135 ± 0.021
  • Prediction performance for luminal expansion following IVL, lesion level: adjusted R2 P < 0.001
  • Prediction performance for luminal expansion following IVL, lesion level: root mean square error P < 0.001

Morphological predictors of poststenting luminal expansion

Lumen and calcium circularity, eccentricity of vessel wall, and balance of calcium to lumen area identified as significant predictors
P < 0.001

Procedural parameters and poststenting luminal expansion

Maximum stent diameter and IVL catheter size associated with poststenting luminal expansion
P < 0.001

Original publication

Deep Learning-Based Assessment of Coronary Artery Morphologies for Predicting Responsiveness to Intravascular Lithotripsy. JACC Adv. Published 6 August 2026. doi:10.1016/j.jacadv.2026.103155

Summarised from the published abstract; every number is checked against it