A Prospective, Multicenter, Real-World Registry of Coronary Lithotripsy in Calcified Coronary Arteries: The REPLICA-EPIC18 Study
Authors' conclusion
Coronary IVL proved to be a feasible and safe procedure in a "real-life" setting, effectively facilitating stent implantation in severely calcified lesions. Patients with ACS on admission showed similar angiographic success rates but showed a trend toward higher 30-day MACE compared with patients with CCS.
Study context
- Population
- Consecutive all-comer patients with calcified coronary lesions treated with intravascular lithotripsy (IVL), 26 centres in Spain
- Participants
- 426 patients · 456 lesions
- Exposure
- Acute coronary syndrome (ACS) vs chronic coronary syndrome (CCS) in patients treated with coronary IVL
- Outcome
- Procedural success (successful IVL delivery, final diameter stenosis <20%, no in-hospital MACE)
Methodological detailsmulticentre, consecutive patients, independent core laboratory, 26 centres in Spain, predefined substudy ACS vs CCS
- Multicentre
- Consecutive patients
- Independent core laboratory
- 26 centres in Spain
- Predefined substudy ACS vs CCS
Main finding
As reported in the abstract
Procedural success (primary effectiveness endpoint)
- Primary effectiveness endpoint achieved, all patients
- 66%
Observational data: associations, not effects.
Further findings
IVL delivery success
- IVL delivery successful
- 99%
Lesions undilatable before IVL
- Lesions considered undilatable before IVL
- 49%
Angiographic success after IVL
- No significant differences between CCS and ACS
Safety
MACE (primary safety endpoint) · 30 days
P = 0.073
- MACE (primary safety endpoint) — MACE at 30 days, all patients
- 3%
Original publication
A Prospective, Multicenter, Real-World Registry of Coronary Lithotripsy in Calcified Coronary Arteries: The REPLICA-EPIC18 Study. JACC Cardiovasc Interv. Published 21 February 2024. doi:10.
Summarised from the published abstract; every number is checked against it