Intravascular lithotripsy during percutaneous coronary intervention: current concepts

Gardiner, Roisin; Muradagha, Hani; Kiernan, Thomas J.

doi:10.1080/14779072.2022.2069561

Cited by 9 publications

(4 citation statements)

References 70 publications

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“…On the other hand, the NC balloon dilatation, in terms of eccentric calcium plaque, may direct the dilatation forces toward the non-calcified segments of the artery with a faint effect on calcium nodules. On the other hand, the S-IVL is a bulky device focused on the disruption of deep calcium plaque with the inability to cross through high-grade stenosis lesions [ 35 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Rota-Lithotripsy as a Novel Bail-Out Strategy for Highly Calcified Coronary Lesions in Acute Coronary Syndrome

Rola

Furtan

Włodarczak³

et al. 2022

Biomedicines

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Background: Heavily calcified lesions in acute coronary syndrome (ACS) still represent a challenging subset for percutaneous coronary intervention (PCI). Rota-lithotripsy—a marriage of rotational atherectomy and intravascular lithotripsy—has recently been introduced to clinical practice as a novel therapeutic option. Methods: This study is among the to present the 6-month clinical outcomes of rota-lithotripsy when performed in the ACS setting. The study cohort consisted of 15 consecutive ACS patients who underwent a rota-lithotripsy-PCI due to the presence of a highly calcified, undilatable lesion. Results: The procedural success ratio reached 100%. During the 6-month follow-up, in two of the patients, instances of MACE (major adverse cardiac events) occurred, including one fatal event. Additionally, during the observation period, one target lesion failure, due to subacute stent thrombosis, was identified. Conclusions: Rotational atherectomy with the subsequent use of shockwave intravascular lithotripsy appears to be a safe and effective therapeutic bail-out option for the management of highly calcified coronary artery lesions. Despite, these initial favorable outcomes, carrying out a large number of studies with long-term observations is still necessary in order to establish the potential benefits and shortcomings of rota-lithotripsy.

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Section: Discussionmentioning

confidence: 99%

Rota-Lithotripsy as a Novel Bail-Out Strategy for Highly Calcified Coronary Lesions in Acute Coronary Syndrome

Rola

Furtan

Włodarczak³

et al. 2022

Biomedicines

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“…[53][54][55] The safety and effectiveness of IVL have been reported across multiple clinical studies wherein severely calcified coronary and peripheral arteries were treated, and IVL now plays an important role in current clinical practice (Supplementary Table 1). 56,57…”

Section: Intravascular Lithotripsymentioning

confidence: 99%

Management of Calcified Coronary Lesions

Al-Shaibi,

Bharadwaj,

Mathur

et al. 2024

US Cardiol

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With an aging population, coronary calcification is increasingly encountered in modern day interventional practice. Unfortunately, it is associated with lower procedural success and higher rates of periprocedural complications, such as failure to deliver stents, perforations, dissections, and other major adverse cardiac events. Furthermore, suboptimal stent deployment in the setting of severe calcification is associated with both short- and long-term major adverse cardiac events, including stent thrombosis, MI, in-stent restenosis, and target lesion revascularization. A variety of treatment options for these lesions exist, including specialized balloons, atherectomy, and intravascular lithotripsy. While there is currently no universally accepted algorithm for choosing between these treatment strategies, several different algorithms exist, and the optimization of these treatment regimens will continue to evolve in the coming years. This review aims to provide insights on the different therapeutic modalities and an understanding of the current body of evidence.

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“…The biological safety of the procedure was finally confirmed in another report in which the same device was employed to treat an in vitro reconstituted valve tissue, where no major ruptures and no changes in cell viability were observed ( 53 ). At the moment, it is not known whether the delivery of shockwaves to the leaflets results into an induction of inflammation and/or cellular apoptosis ( 54 ) and the permanence of smaller deposits resulting from the fragmentation of the large calcific nodules causes long-term effects on mechanical performance of the valve. Another important aspect of this potentially new treatment will probably be the necessity to employ, concomitantly to shockwaves delivery, embolic protection devices able to filter out from the blood the debris deriving from the calcium deposits fragmentation.…”

Section: Use Of Shockwaves In Treatment Of Cardiovascular Diseasesmentioning

confidence: 99%

Shockwaves delivery for aortic valve therapy—Realistic perspective for clinical translation?

Curini

Pesce

2023

Front. Cardiovasc. Med.

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Calcific aortic valve disease (CAVD) is the most frequent valvular heart disorder, and the one with the highest impact and burden in the elderly population. While the quality and standardization of the current aortic valve replacements has reached unprecedented levels with the commercialization of minimally-invasive implants and the design of procedures for valve repair, the need of supplementary therapies able to block or retard the course of the pathology before patients need the intervention is still awaited. In this contribution, we will discuss the emerging opportunity to set up devices to mechanically rupture the calcium deposits accumulating in the aortic valve and restore, at least in part, the pliability and the mechanical function of the calcified leaflets. Starting from the evidences gained by mechanical decalcification of coronary arteries in interventional cardiology procedures, a practice already in the clinical setting, we will discuss the advantages and the potential drawbacks of valve lithotripsy devices and their potential applicability in the clinical scenario.

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Intravascular lithotripsy during percutaneous coronary intervention: current concepts

Cited by 9 publications

References 70 publications

Rota-Lithotripsy as a Novel Bail-Out Strategy for Highly Calcified Coronary Lesions in Acute Coronary Syndrome

Rota-Lithotripsy as a Novel Bail-Out Strategy for Highly Calcified Coronary Lesions in Acute Coronary Syndrome

Management of Calcified Coronary Lesions

Shockwaves delivery for aortic valve therapy—Realistic perspective for clinical translation?

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