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Irish Journal of Medical Science (1971 -)
Published in:

09-07-2022 | Original Article

Intravascular lithotripsy-assisted PCI for severely calcified coronary lesions: evaluating the impact on quality of life and outcomes

Authors: Anthony J. Buckley, John P. McCormick, James Carey, Richard Armstrong, Andrew Maree, Mark Hensey, Stephen O’Connor, Ross Murphy, Caroline Daly, John Cosgrave, Ian Pearson

Published in: Irish Journal of Medical Science (1971 -) | Issue 3/2023

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Abstract

Background

Despite the increased uptake of intravascular lithotripsy (IVL) for treating severely calcified coronary lesions, there is limited patient-level data examining the effect of IVL on quality of life, symptomatology, and outcomes beyond 30 days. We sought to assess demographics, procedural characteristics, outcomes, and impact of IVL on patient-reported angina after a minimum of 6 months follow-up.

Methods

A retrospective single-center study was conducted of patients treated with coronary IVL between January and October 2020. Baseline demographics were obtained from electronic patient records and SYNTAX scores were calculated from index coronary angiograms. Technical success and complications were assessed along with clinical outcomes, which included all-cause mortality, myocardial infarction (MI), target lesion revascularization (TLR), and MACE (composite of death, stroke, MI, and TLR). Canadian Cardiovascular Society (CCS) angina classification was assessed at virtual clinical follow-up.

Results

Forty-seven consecutive patients were included. At a mean follow-up of 306 ± 74 days, the mean CCS angina score was reduced by 53% post-IVL-assisted PCI (2.9 vs 1.4, p < 0.001). Technical and procedural success were high (94% and 92%, respectively). One patient (2%) met the pre-specified criteria for in-hospital MACE and 4 (9%) met pre-specified MACE at follow-up, including 2 deaths and 2 TLR. Procedural complications included coronary dissection (11%) and coronary perforation (6%) and were managed either conservatively or with PCI.

Conclusions

Coronary IVL is a safe and effective adjunctive therapy for treating heavily calcified coronary lesions. This cohort shows high procedural success and a significant reduction in CCS angina at follow-up.
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Metadata
Title
Intravascular lithotripsy-assisted PCI for severely calcified coronary lesions: evaluating the impact on quality of life and outcomes
Authors
Anthony J. Buckley
John P. McCormick
James Carey
Richard Armstrong
Andrew Maree
Mark Hensey
Stephen O’Connor
Ross Murphy
Caroline Daly
John Cosgrave
Ian Pearson
Publication date
09-07-2022
Publisher
Springer International Publishing
Published in
Irish Journal of Medical Science (1971 -) / Issue 3/2023
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-022-03077-9

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