Mid-term outcome of de novo lesions vs. in stent restenosis treated by intravascular lithotripsy procedures: Insights from the French Shock Initiative

医学 狼牙棒 传统PCI 经皮冠状动脉介入治疗 心肌梗塞 再狭窄 心脏病学 支架 内科学 队列 临床终点 靶病变 外科 随机对照试验
作者
Benjamin Honton,Janusz Lipiecki,Jacques Monségu,Fabrice Leroy,Hakim Benamer,Philippe Commeau,Pascal Motreff,Guillaume Cayla,Jean Luc Banos,Gael Bouchou,Clémence Laperche,Bruno Farah,Grégoire Rangé,Thierry Lefèvre,Nicolas Amabile
出处
期刊:International Journal of Cardiology [Elsevier BV]
卷期号:365: 106-111 被引量:10
标识
DOI:10.1016/j.ijcard.2022.07.023
摘要

Intravascular lithotripsy (IVL) is a promising new technology for disrupting de-novo calcified coronary lesions (DNL) before percutaneous coronary intervention (PCI). We assessed 12-month outcomes of IVL in patients undergoing PCI for DNL or intra stent restenosis (ISR) lesions related to device underexpansion.Prospective analysis of patients in the multicentre all-comers French Shock Initiative IVL registry. The primary safety endpoints in this analysis were in-hospital and 12-month major adverse cardiovascular events (MACE: cardiac death, myocardial infarction or target vessel revascularization). The primary effectiveness endpoint was procedural success, defined as <30% residual stenosis without severe angiographic complications. Event rates were analysed for the cohort and for DNL and ISR procedures separately.A total of 220 lesions were treated (76.7% DNL and 23.3% ISR) in 202 patients. Procedural success was achieved in 95.5% of patients (DNL group: 96.5%; ISR group: 92.0%). In-hospital MACE occurred in 6.4% of cases, mainly driven by periprocedural infarctions. The rate of MACE-free survival at 1 year was 86.6% in the overall cohort. Rates of target vessel (TVR) and lesion (TLR) revascularisation were 6.4% and 2.5%, respectively. The 1-year MACE rate was 91.5% in DNL group and 83.8% in ISR group.In this large all-comers IVL cohort, rates of in-hospital and 1-year MACE were moderate. The safety and efficiency of IVL was comparable in DNL and ISR lesions. A comparative study of the impact of IVL on outcomes appears warranted.
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