Impact of coronary calcium morphology on intravascular lithotripsy
Authors' conclusion
In this prospective, multicentre study, the effectiveness of IVL followed by stenting was not significantly affected by coronary calcium morphology.
Study context
- Population
- Patients with calcified coronary lesions undergoing intravascular lithotripsy (IVL) and stenting, with optical coherence tomography (OCT) before and after IVL and after stentinglesions in 90 patients
- Participants
- 95 lesions
- Exposure
- Concentric vs eccentric calcified coronary lesions treated with IVL
- Concentricn = 47
- Eccentricn = 48reference
- Outcome
- Angiographic success (residual stenosis <20%) and presence of fracture by OCT
Methodological detailsmulticentre, 13 tertiary referral centres
- Multicentre
- 13 tertiary referral centres
Main finding
As reported in the abstract
Fracture by OCT; angiographic success
Fracture
P = 0.165
Angiographic success
P = 0.196
Observational data: associations, not effects.
Further findings
≥3 fractures/lesion
P = 0.029
Final minimum lumen area by OCT
P = 0.570
Minimum stent expansion
P > 0.05
Stent expansion at maximum calcium site
P > 0.05
| Outcome | Concentric | Eccentric | P value |
|---|---|---|---|
| Number of fractures/lesion | 4.2 ± 4.4 | 2.3 ± 2.8 | P = 0.018 |
| Minimum stent area by OCT | 5.9 ± 2.2 mm² | 6.25 ± 2.4 mm² | P = 0.483 |
Calcified nodules
- Calcified nodules (% of lesions)
- 29.5%
- Non-eruptive nodules
- 57%
- At nodule site, dissection more common than fracture; stent expansion
- 103.6±27.2%
Median number of pulses
- Median number of pulses (no difference between groups)
- 60 (p=1.00)
Original publication
Impact of coronary calcium morphology on intravascular lithotripsy. EuroIntervention. Published 20 May 2024. doi:10.
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