Intravascular lithotripsy in calcified coronary lesions-A single tertiary care center experience from India

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Aims Severe coronary calcification is a serious impediment to optimal stent expansion and can lead to stent failure and adverse outcomes. We hereby present Indian experience with intravascular lithotripsy(IVL) for the treatment of calcific lesions in acute and chronic coronary syndromes at our tertiary care center. Methods and results This is a single-center prospective study of all patients treated with intravascular lithotripsy (IVL) between June 2021 and June 2022. Patient demographics, procedural variables, and treatment outcomes and early MACE(30 days) were evaluated. During this period, there were 25 patients and 30 coronary lesions were treated with IVL-assisted percutaneous coronary intervention (PCI). The mean age of study population is 72.8±9.0 years. 96% of the study population were male. 88% of the study population were hypertensives and 68% were diabetics. Indications for PCI were acute coronary syndromes in 10 patients (40%), and chronic coronary syndrome in 13 patients (52 %). Optical Coherence Tomography (OCT) was used in 28% of the patients and Intravascular ultrasound(IVUS) was used in 12% of the patients. Rotablation was used in 12% of the patients. Upfront IVL usage was done in 32% of cases and rest of the cases (68%) IVL was done for suboptimal initial balloon pre dilatation or stent under expansion. Angiographic success (<20% residual stenosis) and final thrombolysis in myocardial infarction (TIMI) 3 flow occurred in 24 patients(96%).One patient (4%)had in hospital death post procedure. Conclusions IVL appears to be a safe and effective modality in modifying coronary calcium to achieve optimal stent expansion with low early MACE(Major adverse cardiovascular events).