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Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry
Background: Whereas the efficacy and safety of intravascular lithotripsy (IVL) have been confirmed in de novo calcified coronary lesions, little is known about its utility in treating stent underexpansion. This study aimed to investigate the impact of IVL in treating stent underexpansion. Methods an...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000023/ https://www.ncbi.nlm.nih.gov/pubmed/35407387 http://dx.doi.org/10.3390/jcm11071779 |
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author | Wańha, Wojciech Tomaniak, Mariusz Wańczura, Piotr Bil, Jacek Januszek, Rafał Wolny, Rafał Opolski, Maksymilian P. Kuźma, Łukasz Janas, Adam Figatowski, Tomasz Gąsior, Paweł Milewski, Marek Roleder-Dylewska, Magda Lewicki, Łukasz Kulczycki, Jan Włodarczak, Adrian Tomasiewicz, Brunon Iwańczyk, Sylwia Sacha, Jerzy Koltowski, Łukasz Dziarmaga, Miłosz Jaguszewski, Miłosz Kralisz, Paweł Olajossy, Bartosz Sobieszek, Grzegorz Dyrbuś, Krzysztof Łebek, Mariusz Smolka, Grzegorz Reczuch, Krzysztof Gil, Robert J. Dobrzycki, Sławomir Kwiatkowski, Piotr Rogala, Marcin Gąsior, Mariusz Ochała, Andrzej Kochman, Janusz Witkowski, Adam Lesiak, Maciej D’Ascenzo, Fabrizio Bartuś, Stanisław Wojakowski, Wojciech |
author_facet | Wańha, Wojciech Tomaniak, Mariusz Wańczura, Piotr Bil, Jacek Januszek, Rafał Wolny, Rafał Opolski, Maksymilian P. Kuźma, Łukasz Janas, Adam Figatowski, Tomasz Gąsior, Paweł Milewski, Marek Roleder-Dylewska, Magda Lewicki, Łukasz Kulczycki, Jan Włodarczak, Adrian Tomasiewicz, Brunon Iwańczyk, Sylwia Sacha, Jerzy Koltowski, Łukasz Dziarmaga, Miłosz Jaguszewski, Miłosz Kralisz, Paweł Olajossy, Bartosz Sobieszek, Grzegorz Dyrbuś, Krzysztof Łebek, Mariusz Smolka, Grzegorz Reczuch, Krzysztof Gil, Robert J. Dobrzycki, Sławomir Kwiatkowski, Piotr Rogala, Marcin Gąsior, Mariusz Ochała, Andrzej Kochman, Janusz Witkowski, Adam Lesiak, Maciej D’Ascenzo, Fabrizio Bartuś, Stanisław Wojakowski, Wojciech |
author_sort | Wańha, Wojciech |
collection | PubMed |
description | Background: Whereas the efficacy and safety of intravascular lithotripsy (IVL) have been confirmed in de novo calcified coronary lesions, little is known about its utility in treating stent underexpansion. This study aimed to investigate the impact of IVL in treating stent underexpansion. Methods and Results: Consecutive patients with stent underexpansion treated with IVL entered the multicenter IVL-Dragon Registry. The procedural success (primary efficacy endpoint) was defined as a relative stent expansion >80%. Thirty days device-oriented composite endpoint (DOCE) (defined as a composite of cardiac death, target lesion revascularization, or target vessel myocardial infarction) was the secondary endpoint. A total of 62 patients were enrolled. The primary efficacy endpoint was achieved in 72.6% of patients. Both stent underexpansion 58.5% (47.5–69.7) vs. 11.4% (5.8–20.7), p < 0.001, and the stenotic area 82.6% (72.4–90.8) vs. 21.5% (11.1–37.2), p < 0.001, measured by quantitative coronary angiography improved significantly after IVL. Intravascular imaging confirmed increased stent expansion following IVL from 37.5% (16.0–66.0) to 86.0% (69.2–90.7), p < 0.001, by optical coherence tomography and from 57.0% (31.5–77.2) to 89.0% (85.0–92.0), p = 0.002, by intravascular ultrasound. Secondary endpoint occurred in one (1.6%) patient caused by cardiac death. There was no target lesion revascularization or target vessel myocardial infarction during the 30-day follow-up. Conclusions: In this real-life, largest-to-date analysis of IVL use to manage underexpanded stent, IVL proved to be an effective and safe method for facilitating stent expansion and increasing luminal gain. |
format | Online Article Text |
id | pubmed-9000023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90000232022-04-12 Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry Wańha, Wojciech Tomaniak, Mariusz Wańczura, Piotr Bil, Jacek Januszek, Rafał Wolny, Rafał Opolski, Maksymilian P. Kuźma, Łukasz Janas, Adam Figatowski, Tomasz Gąsior, Paweł Milewski, Marek Roleder-Dylewska, Magda Lewicki, Łukasz Kulczycki, Jan Włodarczak, Adrian Tomasiewicz, Brunon Iwańczyk, Sylwia Sacha, Jerzy Koltowski, Łukasz Dziarmaga, Miłosz Jaguszewski, Miłosz Kralisz, Paweł Olajossy, Bartosz Sobieszek, Grzegorz Dyrbuś, Krzysztof Łebek, Mariusz Smolka, Grzegorz Reczuch, Krzysztof Gil, Robert J. Dobrzycki, Sławomir Kwiatkowski, Piotr Rogala, Marcin Gąsior, Mariusz Ochała, Andrzej Kochman, Janusz Witkowski, Adam Lesiak, Maciej D’Ascenzo, Fabrizio Bartuś, Stanisław Wojakowski, Wojciech J Clin Med Article Background: Whereas the efficacy and safety of intravascular lithotripsy (IVL) have been confirmed in de novo calcified coronary lesions, little is known about its utility in treating stent underexpansion. This study aimed to investigate the impact of IVL in treating stent underexpansion. Methods and Results: Consecutive patients with stent underexpansion treated with IVL entered the multicenter IVL-Dragon Registry. The procedural success (primary efficacy endpoint) was defined as a relative stent expansion >80%. Thirty days device-oriented composite endpoint (DOCE) (defined as a composite of cardiac death, target lesion revascularization, or target vessel myocardial infarction) was the secondary endpoint. A total of 62 patients were enrolled. The primary efficacy endpoint was achieved in 72.6% of patients. Both stent underexpansion 58.5% (47.5–69.7) vs. 11.4% (5.8–20.7), p < 0.001, and the stenotic area 82.6% (72.4–90.8) vs. 21.5% (11.1–37.2), p < 0.001, measured by quantitative coronary angiography improved significantly after IVL. Intravascular imaging confirmed increased stent expansion following IVL from 37.5% (16.0–66.0) to 86.0% (69.2–90.7), p < 0.001, by optical coherence tomography and from 57.0% (31.5–77.2) to 89.0% (85.0–92.0), p = 0.002, by intravascular ultrasound. Secondary endpoint occurred in one (1.6%) patient caused by cardiac death. There was no target lesion revascularization or target vessel myocardial infarction during the 30-day follow-up. Conclusions: In this real-life, largest-to-date analysis of IVL use to manage underexpanded stent, IVL proved to be an effective and safe method for facilitating stent expansion and increasing luminal gain. MDPI 2022-03-23 /pmc/articles/PMC9000023/ /pubmed/35407387 http://dx.doi.org/10.3390/jcm11071779 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Wańha, Wojciech Tomaniak, Mariusz Wańczura, Piotr Bil, Jacek Januszek, Rafał Wolny, Rafał Opolski, Maksymilian P. Kuźma, Łukasz Janas, Adam Figatowski, Tomasz Gąsior, Paweł Milewski, Marek Roleder-Dylewska, Magda Lewicki, Łukasz Kulczycki, Jan Włodarczak, Adrian Tomasiewicz, Brunon Iwańczyk, Sylwia Sacha, Jerzy Koltowski, Łukasz Dziarmaga, Miłosz Jaguszewski, Miłosz Kralisz, Paweł Olajossy, Bartosz Sobieszek, Grzegorz Dyrbuś, Krzysztof Łebek, Mariusz Smolka, Grzegorz Reczuch, Krzysztof Gil, Robert J. Dobrzycki, Sławomir Kwiatkowski, Piotr Rogala, Marcin Gąsior, Mariusz Ochała, Andrzej Kochman, Janusz Witkowski, Adam Lesiak, Maciej D’Ascenzo, Fabrizio Bartuś, Stanisław Wojakowski, Wojciech Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry |
title | Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry |
title_full | Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry |
title_fullStr | Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry |
title_full_unstemmed | Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry |
title_short | Intravascular Lithotripsy for the Treatment of Stent Underexpansion: The Multicenter IVL-DRAGON Registry |
title_sort | intravascular lithotripsy for the treatment of stent underexpansion: the multicenter ivl-dragon registry |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000023/ https://www.ncbi.nlm.nih.gov/pubmed/35407387 http://dx.doi.org/10.3390/jcm11071779 |
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