Shockwave intravascular lithotripsy (IVL) for calcified coronary lesions; a real world multicentre European study with long term follow up

Abstract Background The presence of calcium in atherosclerotic plaques is a challenge for successful angioplasty and an independent risk factor restenosis stent thrombosis. Despite conventional tools (non-compliant, scoring cutting balloons rotational atherectomy), cracking can still be challenging incomplete. Intra-vascular lithotripsy (IVL) has shown promising results, although long-term data on safety efficacy from real-world lacking. Purpose This study was undertaken to report outcomes following use IVL European multi-centre experience. Methods multicentre, retrospective observational which we enrolled all patients treated with shockwave November 2018 June 2021. Procedural success, complications hospital events were evaluated. clinical during follow-up included cardiac death, target vessel myocardial infarction (TVMI), lesion revascularisation (TLR), major adverse event (MACE) (composite TVMI, TVR). Result A total 272 IVL, mean age 72 9.1 years 78.5% (n=216) male. Forty percent (n=110) diabetic while 16% (n=45) had chronic kidney disease. Acute coronary syndrome the presentation 36% (n=99) 51% (n=141) stable angina. De novo lesions accounted 78% (n=215) cases remainder in-stent (21%; n=58). LAD commonest artery 50% (n=139) followed by RCA 24% (n=68). Intracoronary imaging performed 33% cases. Upfront strategy adopted 37% (n=101) 63% (n=171) bail out procedures due inadequate pre dilatation. Adjuvant atherectomy used 31 (11.4%) success achieved 96% (260) 8 (perforation requiring covered 3 patients) but there no in-hospital mortality. Clinical over median follow up 641 days are table. Conclusion largest multicentre registry long term up. It demonstrated that appears safe high rates, low rates complication show results hard-endpoints revascularization rates. Funding Acknowledgement Type funding sources: None.