TCT-155 Retrospective Multicenter Analysis of Intravascular Lithotripsy Use During Imaging-Guided Calcified Left Main Coronary Artery Percutaneous Coronary Interventions
Recommended Citation
Riley R, Miller L, Davies R, Alaswad K, Doshi D, Jaffer F, Adusumalli S, Frizzell J, Kumar K, Patel M, Dakroub A, Ali Z. TCT-155 Retrospective Multicenter Analysis of Intravascular Lithotripsy Use During Imaging-Guided Calcified Left Main Coronary Artery Percutaneous Coronary Interventions. 2023; :B60.
Document Type
Conference Proceeding
Publication Date
10-24-2023
Abstract
Background: Data regarding the use of intravascular lithotripsy (IVL) to treat calcified left main coronary artery (LMCA) lesions are limited. This study aimed to evaluate short-term outcomes of IVL-assisted LMCA PCI. Methods: This retrospective multicenter study enrolled patients who received intravascular imaging–guided, IVL-assisted PCI for severely calcified LMCA lesions. This was an all-comers study that included both acute and stable coronary artery disease (CAD). Clinical and procedural characteristics were obtained, including intravascular imaging results. Technical success was defined as successful stent deployment with <30% residual stenosis. Major adverse cardiac events (MACE) included death, myocardial infarction, and target vessel revascularization evaluated immediately after procedure and at 30-day follow-up. Results: Among 184 patients treated at 7 centers from 2019 to 2023, the majority (65.8%) were treated for acute coronary syndromes. IVL balloons were delivered in 100% of lesions and enabled 99.5% PCI technical success. Calcium fracture was identified in 82.4% of patients on post-PCI intravascular imaging. Pretreatment minimal luminal area increased significantly compared with post-PCI minimal stent area (MSA): 4.1 ± 1.3 to 9.3 ± 2.4 mm2 (P < 0.001). There was a direct correlation between the employed IVL balloon size and the resulting MSA (P = 0.002). In-hospital MACE was 4.4% and 30-day MACE was 8.8% (Table 1). In multivariate logistic regression, presentation with an acute myocardial infarction was the sole predictor of 30-day MACE, including all-cause death. [Formula presented] Conclusion: IVL-assisted PCI for calcified LMCA lesions was safe and resulted in excellent technical success rates, indicating its potential as a viable treatment approach in this challenging patient population. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)
First Page
B60
