Technical and Target Lesion Failure in Calcified Coronary Lesions: Residual Risk Beyond Successful Lithotripsy
Authors' conclusion
Our findings demonstrate that residual risk in IVL-assisted percutaneous coronary intervention is driven by a distinct interplay of modifiable and nonmodifiable factors, rather than inherent limitations of the technology itself.
Study context
- Population
- Patients with calcified coronary lesions treated with intravascular lithotripsy (IVL)-assisted percutaneous coronary intervention, with complete quantitative coronary analysispatients (including 595 target lesions)
- Participants
- 571 patients
- Outcome
- Technical failure (unsuccessful IVL delivery, residual stenosis >30%, or procedural complications); 12-month TLF (cardiac death, target-vessel myocardial infarction, or ischemia-driven revascularization)
- Follow-up
- 12-month (TLF)
Main finding
As reported in the abstract
Technical failure, lesions
60
10.5%
12-month target lesion failure (TLF), cases
41
7.2%
Observational data: associations, not effects.
Further findings
Independent determinants of technical failure (multivariable analysis)
| Comparison | OR (95% CI) | |
|---|---|---|
| Multivessel disease | 1.39 (1.02–1.90) | |
| In-stent lesions | 1.94 (1.14–3.30) | |
| Absence of intravascular imaging | 1.95 (1.13–3.40) | |
| 0.20.5125Odds ratio (log scale) |
Factors independently associated with TLF
| Comparison | HR (95% CI) | |
|---|---|---|
| Left circumflex | 2.97 (1.49–5.92) | |
| In-stent target lesions | 2.01 (1.02–3.52) | |
| Technical failure | 2.42 (1.26–4.61) | |
| Diabetes mellitus | 2.35 (1.23–4.47) | |
| Reduced estimated glomerular filtration rate | 0.98 (0.97–0.99) | |
| Younger age | 0.95 (0.92–0.98) | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Technical and Target Lesion Failure in Calcified Coronary Lesions: Residual Risk Beyond Successful Lithotripsy. JACC Adv. Published 15 July 2026. doi:10.
Summarised from the published abstract; every number is checked against it