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Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions

BACKGROUND: Data regarding safety, efficacy, and outcome of intravascular lithotripsy (IVL) in comparison to standard techniques are lacking. This study sought to compare IVL with non-compliant high-pressure balloon percutaneous coronary angioplasty (PTCA). METHODS AND RESULTS: We performed a retros...

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Autores principales: Aksoy, Adem, Tiyerili, Vedat, Jansen, Nora, Al Zaidi, Muntadher, Thiessen, Maximillian, Sedaghat, Alexander, Ulrich Becher, Marc, Jansen, Felix, Nickenig, Georg, Zimmer, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671124/
https://www.ncbi.nlm.nih.gov/pubmed/34950765
http://dx.doi.org/10.1016/j.ijcha.2021.100900
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author Aksoy, Adem
Tiyerili, Vedat
Jansen, Nora
Al Zaidi, Muntadher
Thiessen, Maximillian
Sedaghat, Alexander
Ulrich Becher, Marc
Jansen, Felix
Nickenig, Georg
Zimmer, Sebastian
author_facet Aksoy, Adem
Tiyerili, Vedat
Jansen, Nora
Al Zaidi, Muntadher
Thiessen, Maximillian
Sedaghat, Alexander
Ulrich Becher, Marc
Jansen, Felix
Nickenig, Georg
Zimmer, Sebastian
author_sort Aksoy, Adem
collection PubMed
description BACKGROUND: Data regarding safety, efficacy, and outcome of intravascular lithotripsy (IVL) in comparison to standard techniques are lacking. This study sought to compare IVL with non-compliant high-pressure balloon percutaneous coronary angioplasty (PTCA). METHODS AND RESULTS: We performed a retrospective propensity-score-matched study to compare procedural success in 57 consecutive patients who received IVL-guided PCI in calcified coronary lesions with 171 matched patients who were treated with high-pressure PTCA with a non-compliant (NC)-balloon. The mean minimal lumen diameter (MLD) for the IVL group was 1.08 ± 0.51 mm, and the median percent diameter stenosis on quantitative angiography was 70.2% (interquartile range, 60.2–78.6%). MLD in the high-pressure dilatation group was 0.97 ± 0.43 mm, and the median percent diameter stenosis was 71.5% (interquartile range, 58.5–77.0%). IVL-guided PCI reduced median stenosis to 17.5% (interquartile range, 9.3–19.8%) with an acute gain of 0.93 ± 0.7 mm. High-pressure dilatation resulted in a final median stenosis of 19.3% (interquartile range, 13.33–28.5%). Procedural success was significantly higher (82.5% vs. 61.4%; p: 0.0035) in the IVL group. MACE through 12 months occurred in 10.5% of cases in the IVL group and in 11.1% of the high-pressure group (p = 0.22). Angiographic complications (coronary dissection, slow or no reflow, new coronary thrombus formation, abrupt vessel closure) were very low (0.2% vs. 0.12%). CONCLUSION: IVL resulted in a significantly higher rate of procedural success compared to high- pressure NC-balloon dilatation in patients with calcified coronary lesions. The rate of MACE through 12 months was similar to the standard therapy.
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spelling pubmed-86711242021-12-22 Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions Aksoy, Adem Tiyerili, Vedat Jansen, Nora Al Zaidi, Muntadher Thiessen, Maximillian Sedaghat, Alexander Ulrich Becher, Marc Jansen, Felix Nickenig, Georg Zimmer, Sebastian Int J Cardiol Heart Vasc Original Paper BACKGROUND: Data regarding safety, efficacy, and outcome of intravascular lithotripsy (IVL) in comparison to standard techniques are lacking. This study sought to compare IVL with non-compliant high-pressure balloon percutaneous coronary angioplasty (PTCA). METHODS AND RESULTS: We performed a retrospective propensity-score-matched study to compare procedural success in 57 consecutive patients who received IVL-guided PCI in calcified coronary lesions with 171 matched patients who were treated with high-pressure PTCA with a non-compliant (NC)-balloon. The mean minimal lumen diameter (MLD) for the IVL group was 1.08 ± 0.51 mm, and the median percent diameter stenosis on quantitative angiography was 70.2% (interquartile range, 60.2–78.6%). MLD in the high-pressure dilatation group was 0.97 ± 0.43 mm, and the median percent diameter stenosis was 71.5% (interquartile range, 58.5–77.0%). IVL-guided PCI reduced median stenosis to 17.5% (interquartile range, 9.3–19.8%) with an acute gain of 0.93 ± 0.7 mm. High-pressure dilatation resulted in a final median stenosis of 19.3% (interquartile range, 13.33–28.5%). Procedural success was significantly higher (82.5% vs. 61.4%; p: 0.0035) in the IVL group. MACE through 12 months occurred in 10.5% of cases in the IVL group and in 11.1% of the high-pressure group (p = 0.22). Angiographic complications (coronary dissection, slow or no reflow, new coronary thrombus formation, abrupt vessel closure) were very low (0.2% vs. 0.12%). CONCLUSION: IVL resulted in a significantly higher rate of procedural success compared to high- pressure NC-balloon dilatation in patients with calcified coronary lesions. The rate of MACE through 12 months was similar to the standard therapy. Elsevier 2021-12-09 /pmc/articles/PMC8671124/ /pubmed/34950765 http://dx.doi.org/10.1016/j.ijcha.2021.100900 Text en © 2021 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Original Paper
Aksoy, Adem
Tiyerili, Vedat
Jansen, Nora
Al Zaidi, Muntadher
Thiessen, Maximillian
Sedaghat, Alexander
Ulrich Becher, Marc
Jansen, Felix
Nickenig, Georg
Zimmer, Sebastian
Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions
title Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions
title_full Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions
title_fullStr Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions
title_full_unstemmed Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions
title_short Propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure PTCA in coronary calcified lesions
title_sort propensity-score-matched comparison of safety, efficacy, and outcome of intravascular lithotripsy versus high-pressure ptca in coronary calcified lesions
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8671124/
https://www.ncbi.nlm.nih.gov/pubmed/34950765
http://dx.doi.org/10.1016/j.ijcha.2021.100900
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