A Novel Intravascular Lithotripsy System in Severely Calcified Coronary Lesions: The Prospective COronary CAlcified Lesion Lithotripsy Procedure (COCALP) Study

ABSTRACT Intravascular lithotripsy (IVL) is a promising therapy for calcified coronary lesions. This study evaluated the safety and effectiveness of a novel IVL system. The COronary CAlcified Lesion Lithotripsy Procedure (COCALP) study (No. ChiCTR2300073280) was a prospective, multicenter, single‐ar...

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Main Authors: Xin Deng, Yiqing Hu, Guosheng Fu, Genshan Ma, Xuebo Liu, Bei Shi, Jianfang Luo, Jingfeng Wang, Zhixiong Zhong, Hanbin Cui, Likun Ma, Juying Qian, Jian'an Wang, Hao Lu, Junbo Ge
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:MedComm
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Online Access:https://doi.org/10.1002/mco2.70208
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Summary:ABSTRACT Intravascular lithotripsy (IVL) is a promising therapy for calcified coronary lesions. This study evaluated the safety and effectiveness of a novel IVL system. The COronary CAlcified Lesion Lithotripsy Procedure (COCALP) study (No. ChiCTR2300073280) was a prospective, multicenter, single‐arm trial involving 266 patients with severely calcified coronary lesions. The primary endpoint was procedural success, defined as successful stent implantation with ≤30% residual stenosis and no in‐hospital major adverse cardiovascular events (MACE). In a subgroup, calcium morphology was evaluated by optical coherence tomography (OCT) assessment. A total of 266 patients were included. The procedural success rate was 97.4% (95% confidence interval [CI]: 0.947–0.989), with the lower limit of the CI exceeding the prespecified performance goal (p < 0.001). No MACE occurred intraoperatively. During hospitalization, MACE occurred in five patients (1.9%), all of which were myocardial infarctions. MACE rates at 1 and 6 months were 2.3 and 3.4%, respectively. In the OCT subgroup (n = 76), IVL induced a 76.8% rate of calcification fracture. The minimal lumen area increased from 1.77 ± 0.72 to 2.59 ± 1.11 mm2 following IVL (p < 0.001), and further expanded to 5.22 ± 1.69 mm2 poststenting (p < 0.001). The novel IVL system demonstrated high effectiveness and safety, supporting its use for treating severely calcified coronary lesions and enhancing stent implantation success.
ISSN:2688-2663