Intravascular Lithotripsy Versus Rotational Atherectomy in Coronary Chronic Total Occlusions: Analysis from the Prospective Global Registry for the Study of Chronic Total Occlusion Intervention Registry
Recommended Citation
Carvalho PEP, Strepkos D, Alexandrou M, Mutlu D, Ser OS, Choi JW, Gorgulu S, Jaffer FA, Chandwaney R, Alaswad K, Basir MB, Azzalini L, Ozdemir R, Uluganyan M, Khatri J, Young L, Poommipanit P, Aygul N, Davies R, Krestyaninov O, Khelimskii D, Goktekin O, Akyel A, Tuner H, Rafeh NA, Elguindy A, Rangan BV, Mastrodemos OC, Voudris K, Burke MN, Sandoval Y, and Brilakis ES. Intravascular Lithotripsy versus Rotational Atherectomy in Coronary Chronic Total Occlusions: Analysis from the PROGRESS-CTO registry. Am J Cardiol 2024.
Document Type
Article
Publication Date
10-24-2024
Publication Title
The American journal of cardiology
Abstract
BACKGROUND: There is limited comparative data on the use of plaque modification devices during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We compared intravascular lithotripsy (IVL) with rotational atherectomy (RA) for lesion preparation in patients who underwent CTO PCI across 50 US and non-US centers from 2019 to 2024.
RESULTS: Among 15,690 patients who underwent CTO PCI during the study period, 436 (2.78%) underwent IVL and 381 (2.45%) RA. Patients treated with IVL had more comorbidities and more complex CTO lesions. Antegrade wiring was the most commonly used initial and successful crossing strategy for lesions treated with both IVL and RA, although the retrograde approach was more frequently employed in IVL cases. Procedure and fluoroscopy times, as well as air kerma radiation doses and contrast volumes, were higher in patients treated with RA compared with IVL. There were no significant differences between the groups in technical success (97.2% vs. 95.3%, p=0.20), procedural success (94.7% vs. 91.8%, p=0.14), and in-hospital major adverse cardiac events (MACE) (3.0 % vs. 4.2%, p=0.47). However, coronary perforations were more frequent in patients undergoing RA (9.5% vs. 3.2%, p<0.001). Multivariable logistic regression analysis revealed that IVL compared with RA was not independently associated with technical success, procedural success, or in-hospital MACE.
CONCLUSIONS: In patients undergoing CTO PCI, IVL is associated with similar in-hospital MACE, technical success, and procedural success, but lower incidence of coronary perforation, compared with RA.
PubMed ID
39454696
ePublication
ePub ahead of print
Volume
235
First Page
37
Last Page
43
