Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention

Intravascular lithotripsy (IVL) has been shown to be safe and effective for calcium modification in nonocclusive coronary artery disease (CAD), but there are only case reports of its use in calcified chronic total occlusions (CTO). We report data from an international multicenter registry of IVL use...

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Main Authors: Anja Øksnes, Claudia Cosgrove, Simon Walsh, Kjetil Halvorsen Løland, Jack Laffan, Sinjini Biswas, Aadil Shaukat, Colm Hanratty, Julian Strange, James C. S. Spratt, Margaret McEntegart
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2021/9958035
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author Anja Øksnes
Claudia Cosgrove
Simon Walsh
Kjetil Halvorsen Løland
Jack Laffan
Sinjini Biswas
Aadil Shaukat
Colm Hanratty
Julian Strange
James C. S. Spratt
Margaret McEntegart
author_facet Anja Øksnes
Claudia Cosgrove
Simon Walsh
Kjetil Halvorsen Løland
Jack Laffan
Sinjini Biswas
Aadil Shaukat
Colm Hanratty
Julian Strange
James C. S. Spratt
Margaret McEntegart
author_sort Anja Øksnes
collection DOAJ
description Intravascular lithotripsy (IVL) has been shown to be safe and effective for calcium modification in nonocclusive coronary artery disease (CAD), but there are only case reports of its use in calcified chronic total occlusions (CTO). We report data from an international multicenter registry of IVL use during CTO percutaneous coronary intervention (PCI) and provide provisional data regarding its efficacy and safety. During the study period, IVL was used in 55 of 1053 (5.2%) CTO PCI procedures. IVL was used within the occluded segment after successful CTO crossing in 53 procedures and during incomplete CTO crossing in 2 cases. The mean J-CTO score was 3.1. CTO PCI technical and procedural success was achieved in 53 (96%) and 51 (93%) cases. Six patients had a procedural complication, with 3 main vessel perforations (5%). Two had covered stent implantation, one required pericardiocentesis, and one was managed conservatively. All had combination therapy with another calcium modification device. Two patients had a procedural myocardial infarction (PMI) (4%), and two others had a major adverse cardiovascular event (MACE) (4%) at a median follow-up of 13 (4–21) months. IVL can effectively facilitate calcium modification during CTO PCI. More data are required to establish the efficacy and safety of IVL and other calcium modification devices when used extraplaque or in combination during CTO PCI.
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spelling doaj-art-e27309d953754df181c80d36354fa5582025-08-20T02:21:16ZengWileyJournal of Interventional Cardiology0896-43271540-81832021-01-01202110.1155/2021/99580359958035Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary InterventionAnja Øksnes0Claudia Cosgrove1Simon Walsh2Kjetil Halvorsen Løland3Jack Laffan4Sinjini Biswas5Aadil Shaukat6Colm Hanratty7Julian Strange8James C. S. Spratt9Margaret McEntegart10Haukeland University Hospital, Bergen, NorwaySt George’s University Hospital, London, UKBelfast Health and Social Care Trust, Belfast, UKHaukeland University Hospital, Bergen, NorwayBelfast Health and Social Care Trust, Belfast, UKBristol University Hospital, Bristol, UKGolden Jubilee National Hospital, Glasgow, UKBelfast Health and Social Care Trust, Belfast, UKBristol University Hospital, Bristol, UKSt George’s University Hospital, London, UKGolden Jubilee National Hospital, Glasgow, UKIntravascular lithotripsy (IVL) has been shown to be safe and effective for calcium modification in nonocclusive coronary artery disease (CAD), but there are only case reports of its use in calcified chronic total occlusions (CTO). We report data from an international multicenter registry of IVL use during CTO percutaneous coronary intervention (PCI) and provide provisional data regarding its efficacy and safety. During the study period, IVL was used in 55 of 1053 (5.2%) CTO PCI procedures. IVL was used within the occluded segment after successful CTO crossing in 53 procedures and during incomplete CTO crossing in 2 cases. The mean J-CTO score was 3.1. CTO PCI technical and procedural success was achieved in 53 (96%) and 51 (93%) cases. Six patients had a procedural complication, with 3 main vessel perforations (5%). Two had covered stent implantation, one required pericardiocentesis, and one was managed conservatively. All had combination therapy with another calcium modification device. Two patients had a procedural myocardial infarction (PMI) (4%), and two others had a major adverse cardiovascular event (MACE) (4%) at a median follow-up of 13 (4–21) months. IVL can effectively facilitate calcium modification during CTO PCI. More data are required to establish the efficacy and safety of IVL and other calcium modification devices when used extraplaque or in combination during CTO PCI.http://dx.doi.org/10.1155/2021/9958035
spellingShingle Anja Øksnes
Claudia Cosgrove
Simon Walsh
Kjetil Halvorsen Løland
Jack Laffan
Sinjini Biswas
Aadil Shaukat
Colm Hanratty
Julian Strange
James C. S. Spratt
Margaret McEntegart
Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention
Journal of Interventional Cardiology
title Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention
title_full Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention
title_fullStr Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention
title_full_unstemmed Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention
title_short Intravascular Lithotripsy for Calcium Modification in Chronic Total Occlusion Percutaneous Coronary Intervention
title_sort intravascular lithotripsy for calcium modification in chronic total occlusion percutaneous coronary intervention
url http://dx.doi.org/10.1155/2021/9958035
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