Contemporary Trends and Outcomes of Intravascular Lithotripsy in Percutaneous Coronary Intervention: Insights From BMC2
Recommended Citation
Sukul D, Seth M, Madder RD, Basir MB, Menees DS, Kaki A, Azzalini L, Lee D, and Gurm HS. Contemporary Trends and Outcomes of Intravascular Lithotripsy in Percutaneous Coronary Intervention: Insights From BMC2. JACC Cardiovasc Interv 2024.
Document Type
Article
Publication Date
8-12-2024
Publication Title
JACC Cardiovasc Interv
Abstract
BACKGROUND: With an aging population and an increase in the comorbidity burden of patients undergoing percutaneous coronary intervention (PCI), the management of coronary calcification for optimal PCI is critical in contemporary practice.
OBJECTIVES: This study sought to examine the trends and outcomes of coronary intravascular lithotripsy (IVL), rotational/orbital atherectomy, or both among patients who underwent PCI in Michigan.
METHODS: We included all PCIs between January 1, 2021, and June 30, 2022, performed at 48 Michigan hospitals. Outcomes included in-hospital major adverse cardiac events (MACEs) and procedural success.
RESULTS: IVL was used in 1,090 patients (2.57%), atherectomy was used in 1,743 (4.10%) patients, and both were used in 240 patients (0.57% of all PCIs). IVL use increased from 0.04% of PCI cases in January 2021 to 4.28% of cases in June 2022, ultimately exceeding the rate of atherectomy use. The rate of MACEs (4.3% vs 5.4%; P = 0.23) and procedural success (89.4% vs 89.1%; P = 0.88) were similar among patients treated with IVL compared with atherectomy, respectively. Only 15.6% of patients treated with IVL in contemporary practice were similar to the population enrolled in the pivotal IVL trials. Among such patients (n = 169), the rate of MACEs (0.0%) and procedural success (94.7%) were similar to the outcomes reported in the pivotal IVL trials.
CONCLUSIONS: Since its introduction in February 2021, coronary IVL use has steadily increased, exceeding atherectomy use in Michigan by February 2022. Contemporary use of IVL and atherectomy is generally associated with high rates of procedural success and low rates of complications.
Medical Subject Headings
Humans; Percutaneous Coronary Intervention; Male; Michigan; Aged; Treatment Outcome; Female; Lithotripsy; Atherectomy, Coronary; Coronary Artery Disease; Vascular Calcification; Middle Aged; Time Factors; Risk Factors; Risk Assessment; Practice Patterns, Physicians'; Aged, 80 and over; Registries; Retrospective Studies
PubMed ID
38970579
ePublication
ePub ahead of print
Volume
17
Issue
15
First Page
1811
Last Page
1821
