Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with severe calcification: A multicenter systematic review and meta‐analysis
Background With heavily calcified coronary and peripheral artery lesions, lesion preparation is crucial before stent placement to avoid underexpansion, associated with stent thrombosis or restenosis and patency failure in the long‐term. Intravascular lithotripsy (IVL) technology disrupts superficial...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2024-04, Vol.103 (5), p.710-721 |
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| creator | Sagris, Marios Ktenopoulos, Nikolaos Dimitriadis, Kyriakos Papanikolaou, Angelos Tzoumas, Andreas Terentes‐Printzios, Dimitrios Synetos, Andreas Soulaidopoulos, Stergios Lichtenberg, Michael Korosoglou, Grigorios Honton, Benjamin Tousoulis, Dimitris Tsioufis, Costas Toutouzas, Konstantinos |
| description | Background
With heavily calcified coronary and peripheral artery lesions, lesion preparation is crucial before stent placement to avoid underexpansion, associated with stent thrombosis or restenosis and patency failure in the long‐term. Intravascular lithotripsy (IVL) technology disrupts superficial and deep calcium by using localized pulsative sonic pressure waves, making it to a promising tool for patients with severe calcification in coronary bed.
Aims
The aim of the study is to systematically review and summarize available data regarding the safety and efficacy of IVL for lesion preparation in severely calcified coronary arteries before stenting.
Methods
This study was conducted according to the PRISMA guidelines. We systematically searched PubMed, SCOPUS, and Cochrane databases from their inception to February 23, 2023, for studies assessing the characteristics and outcomes of patients undergoing IVL before stent implantation. The diameter of the vessel lumen before and after IVL, as well as stent implantation, were analyzed. The occurrence of major adverse cardiovascular events (MACE) was assessed using a random‐effects model.
Results
This meta‐analysis comprised 38 studies including 2977 patients with heavily calcified coronary lesions. The mean age was 72.2 ± 9.1 years, with an overall IVL clinical success of 93% (95% confidence interval [CI]: 91%−95%, I2 = 0%) and procedural success rate of 97% (95% CI: 95%−98%, I2 = 73.7%), while the in‐hospital and 30‐days incidence of MACE, myocardial infarction (MI), and death were 8% (95% CI: 6%−11%, I2 = 84.5%), 5% (95% CI: 2%−8%, I2 = 85.6%), and 2% (95% CI: 1%−3%, I2 = 69.3%), respectively. There was a significant increase in the vessel diameter (standardized mean difference [SMD]: 2.47, 95% CI: 1.77−3.17, I2 = 96%) and a decrease in diameter stenosis (SMD: −3.44, 95% CI: −4.36 to −2.52, I2 = 97.5%) immediately after IVL application, while it was observed further reduction in diameter stenosis (SMD: −6.57, 95% CI: −7.43 to −5.72, I2 = 95.8%) and increase in the vessel diameter (SMD: 4.37, 95% CI: 3.63−5.12, I2 = 96.7%) and the calculated lumen area (SMD: 3.23, 95% CI: 2.10−4.37, I2 = 98%), after stent implantation. The mean acute luminal gain following IVL and stent implantation was estimated to be 1.27 ± 0.6 and 1.94 ± 1.1 mm, respectively. Periprocedural complications were rare, with just a few cases of perforations, dissection, or no‐reflow phenomena recorded.
Conclusions
IVL seems to be a safe and effe |
| doi_str_mv | 10.1002/ccd.31006 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2957168801</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2957168801</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3486-4b3296682f53d9335af51efd5cc28aad92384e10ba58ef0566571bf9a914f94f3</originalsourceid><addsrcrecordid>eNp1kc9uEzEQh1cIREvhwAsgS1zaQ1r_WTs2tyqUUilSL4C4WY53LFx518H2Jtobb9A-I0-C0wQOSD3NSPPNp7F_TfOW4HOCMb2wtjtntRPPmmPCKZ3Nqfj-_NAT1Yqj5lXOdxhjJah62Rwx2UqqqDxu7q-c89bYCUWH_FCS2Zhsx2ASCr78iCX5dZ7Q6c235VmdIxtTHEyaUC4wxOwz2lYMZdhAAmRNsH7nKz4OH9Al6sdQvIWhQEJ5qjt9HVmUYONhi8zQoR6K-f3rwQwmTFX3unnhTMjw5lBPmq-frr4sPs-Wt9c3i8vlzLJWilm7YlQJIanjrFOMceM4Addxa6k0plO0PhEIXhkuwWEuBJ-TlVNGkdap1rGT5nTvXaf4c4RcdO-zhRDMAHHMmqq6IKTEpKLv_0Pv4pjqvVkzzOZcSMF21NmesinmnMDpdfJ9_SlNsN6lpGtK-jGlyr47GMdVD90_8m8sFbjYA1sfYHrapBeLj3vlH8plnnE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3037568631</pqid></control><display><type>article</type><title>Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with severe calcification: A multicenter systematic review and meta‐analysis</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Sagris, Marios ; Ktenopoulos, Nikolaos ; Dimitriadis, Kyriakos ; Papanikolaou, Angelos ; Tzoumas, Andreas ; Terentes‐Printzios, Dimitrios ; Synetos, Andreas ; Soulaidopoulos, Stergios ; Lichtenberg, Michael ; Korosoglou, Grigorios ; Honton, Benjamin ; Tousoulis, Dimitris ; Tsioufis, Costas ; Toutouzas, Konstantinos</creator><creatorcontrib>Sagris, Marios ; Ktenopoulos, Nikolaos ; Dimitriadis, Kyriakos ; Papanikolaou, Angelos ; Tzoumas, Andreas ; Terentes‐Printzios, Dimitrios ; Synetos, Andreas ; Soulaidopoulos, Stergios ; Lichtenberg, Michael ; Korosoglou, Grigorios ; Honton, Benjamin ; Tousoulis, Dimitris ; Tsioufis, Costas ; Toutouzas, Konstantinos</creatorcontrib><description>Background
With heavily calcified coronary and peripheral artery lesions, lesion preparation is crucial before stent placement to avoid underexpansion, associated with stent thrombosis or restenosis and patency failure in the long‐term. Intravascular lithotripsy (IVL) technology disrupts superficial and deep calcium by using localized pulsative sonic pressure waves, making it to a promising tool for patients with severe calcification in coronary bed.
Aims
The aim of the study is to systematically review and summarize available data regarding the safety and efficacy of IVL for lesion preparation in severely calcified coronary arteries before stenting.
Methods
This study was conducted according to the PRISMA guidelines. We systematically searched PubMed, SCOPUS, and Cochrane databases from their inception to February 23, 2023, for studies assessing the characteristics and outcomes of patients undergoing IVL before stent implantation. The diameter of the vessel lumen before and after IVL, as well as stent implantation, were analyzed. The occurrence of major adverse cardiovascular events (MACE) was assessed using a random‐effects model.
Results
This meta‐analysis comprised 38 studies including 2977 patients with heavily calcified coronary lesions. The mean age was 72.2 ± 9.1 years, with an overall IVL clinical success of 93% (95% confidence interval [CI]: 91%−95%, I2 = 0%) and procedural success rate of 97% (95% CI: 95%−98%, I2 = 73.7%), while the in‐hospital and 30‐days incidence of MACE, myocardial infarction (MI), and death were 8% (95% CI: 6%−11%, I2 = 84.5%), 5% (95% CI: 2%−8%, I2 = 85.6%), and 2% (95% CI: 1%−3%, I2 = 69.3%), respectively. There was a significant increase in the vessel diameter (standardized mean difference [SMD]: 2.47, 95% CI: 1.77−3.17, I2 = 96%) and a decrease in diameter stenosis (SMD: −3.44, 95% CI: −4.36 to −2.52, I2 = 97.5%) immediately after IVL application, while it was observed further reduction in diameter stenosis (SMD: −6.57, 95% CI: −7.43 to −5.72, I2 = 95.8%) and increase in the vessel diameter (SMD: 4.37, 95% CI: 3.63−5.12, I2 = 96.7%) and the calculated lumen area (SMD: 3.23, 95% CI: 2.10−4.37, I2 = 98%), after stent implantation. The mean acute luminal gain following IVL and stent implantation was estimated to be 1.27 ± 0.6 and 1.94 ± 1.1 mm, respectively. Periprocedural complications were rare, with just a few cases of perforations, dissection, or no‐reflow phenomena recorded.
Conclusions
IVL seems to be a safe and effective strategy for lesion preparation in severely calcified lesions before stent implantation in coronary arteries. Future prospective studies are now warranted to compare IVL to other lesion preparation strategies.</description><identifier>ISSN: 1522-1946</identifier><identifier>ISSN: 1522-726X</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.31006</identifier><identifier>PMID: 38482928</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Aged, 80 and over ; Calcification ; Calcification (ectopic) ; Calcium signalling ; complications ; coronary arteries ; Coronary artery ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Coronary Artery Disease - therapy ; Coronary Stenosis - diagnostic imaging ; Coronary Stenosis - therapy ; Coronary vessels ; efficacy ; Female ; Humans ; Implants ; intravascular lithotripsy ; Lesions ; Lithotripsy ; Lithotripsy - adverse effects ; major adverse events ; Male ; Meta-analysis ; Middle Aged ; Multicenter Studies as Topic ; Myocardial infarction ; Patients ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - instrumentation ; Percutaneous Coronary Intervention - mortality ; Restenosis ; Risk Assessment ; Risk Factors ; safety ; Severity of Illness Index ; Stents ; success ; Thrombosis ; Time Factors ; Treatment Outcome ; Vascular Calcification - diagnostic imaging ; Vascular Calcification - mortality ; Vascular Calcification - therapy</subject><ispartof>Catheterization and cardiovascular interventions, 2024-04, Vol.103 (5), p.710-721</ispartof><rights>2024 The Authors. published by Wiley Periodicals LLC.</rights><rights>2024 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3486-4b3296682f53d9335af51efd5cc28aad92384e10ba58ef0566571bf9a914f94f3</cites><orcidid>0000-0001-8516-1177 ; 0000-0002-3473-1368 ; 0000-0003-4039-8263 ; 0000-0003-3186-8905 ; 0000-0002-6038-2253 ; 0000-0002-0995-7015 ; 0000-0003-2946-344X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.31006$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.31006$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,1414,27911,27912,45561,45562</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38482928$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sagris, Marios</creatorcontrib><creatorcontrib>Ktenopoulos, Nikolaos</creatorcontrib><creatorcontrib>Dimitriadis, Kyriakos</creatorcontrib><creatorcontrib>Papanikolaou, Angelos</creatorcontrib><creatorcontrib>Tzoumas, Andreas</creatorcontrib><creatorcontrib>Terentes‐Printzios, Dimitrios</creatorcontrib><creatorcontrib>Synetos, Andreas</creatorcontrib><creatorcontrib>Soulaidopoulos, Stergios</creatorcontrib><creatorcontrib>Lichtenberg, Michael</creatorcontrib><creatorcontrib>Korosoglou, Grigorios</creatorcontrib><creatorcontrib>Honton, Benjamin</creatorcontrib><creatorcontrib>Tousoulis, Dimitris</creatorcontrib><creatorcontrib>Tsioufis, Costas</creatorcontrib><creatorcontrib>Toutouzas, Konstantinos</creatorcontrib><title>Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with severe calcification: A multicenter systematic review and meta‐analysis</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Background
With heavily calcified coronary and peripheral artery lesions, lesion preparation is crucial before stent placement to avoid underexpansion, associated with stent thrombosis or restenosis and patency failure in the long‐term. Intravascular lithotripsy (IVL) technology disrupts superficial and deep calcium by using localized pulsative sonic pressure waves, making it to a promising tool for patients with severe calcification in coronary bed.
Aims
The aim of the study is to systematically review and summarize available data regarding the safety and efficacy of IVL for lesion preparation in severely calcified coronary arteries before stenting.
Methods
This study was conducted according to the PRISMA guidelines. We systematically searched PubMed, SCOPUS, and Cochrane databases from their inception to February 23, 2023, for studies assessing the characteristics and outcomes of patients undergoing IVL before stent implantation. The diameter of the vessel lumen before and after IVL, as well as stent implantation, were analyzed. The occurrence of major adverse cardiovascular events (MACE) was assessed using a random‐effects model.
Results
This meta‐analysis comprised 38 studies including 2977 patients with heavily calcified coronary lesions. The mean age was 72.2 ± 9.1 years, with an overall IVL clinical success of 93% (95% confidence interval [CI]: 91%−95%, I2 = 0%) and procedural success rate of 97% (95% CI: 95%−98%, I2 = 73.7%), while the in‐hospital and 30‐days incidence of MACE, myocardial infarction (MI), and death were 8% (95% CI: 6%−11%, I2 = 84.5%), 5% (95% CI: 2%−8%, I2 = 85.6%), and 2% (95% CI: 1%−3%, I2 = 69.3%), respectively. There was a significant increase in the vessel diameter (standardized mean difference [SMD]: 2.47, 95% CI: 1.77−3.17, I2 = 96%) and a decrease in diameter stenosis (SMD: −3.44, 95% CI: −4.36 to −2.52, I2 = 97.5%) immediately after IVL application, while it was observed further reduction in diameter stenosis (SMD: −6.57, 95% CI: −7.43 to −5.72, I2 = 95.8%) and increase in the vessel diameter (SMD: 4.37, 95% CI: 3.63−5.12, I2 = 96.7%) and the calculated lumen area (SMD: 3.23, 95% CI: 2.10−4.37, I2 = 98%), after stent implantation. The mean acute luminal gain following IVL and stent implantation was estimated to be 1.27 ± 0.6 and 1.94 ± 1.1 mm, respectively. Periprocedural complications were rare, with just a few cases of perforations, dissection, or no‐reflow phenomena recorded.
Conclusions
IVL seems to be a safe and effective strategy for lesion preparation in severely calcified lesions before stent implantation in coronary arteries. Future prospective studies are now warranted to compare IVL to other lesion preparation strategies.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Calcification</subject><subject>Calcification (ectopic)</subject><subject>Calcium signalling</subject><subject>complications</subject><subject>coronary arteries</subject><subject>Coronary artery</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary Stenosis - diagnostic imaging</subject><subject>Coronary Stenosis - therapy</subject><subject>Coronary vessels</subject><subject>efficacy</subject><subject>Female</subject><subject>Humans</subject><subject>Implants</subject><subject>intravascular lithotripsy</subject><subject>Lesions</subject><subject>Lithotripsy</subject><subject>Lithotripsy - adverse effects</subject><subject>major adverse events</subject><subject>Male</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Multicenter Studies as Topic</subject><subject>Myocardial infarction</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - instrumentation</subject><subject>Percutaneous Coronary Intervention - mortality</subject><subject>Restenosis</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>safety</subject><subject>Severity of Illness Index</subject><subject>Stents</subject><subject>success</subject><subject>Thrombosis</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vascular Calcification - diagnostic imaging</subject><subject>Vascular Calcification - mortality</subject><subject>Vascular Calcification - therapy</subject><issn>1522-1946</issn><issn>1522-726X</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp1kc9uEzEQh1cIREvhwAsgS1zaQ1r_WTs2tyqUUilSL4C4WY53LFx518H2Jtobb9A-I0-C0wQOSD3NSPPNp7F_TfOW4HOCMb2wtjtntRPPmmPCKZ3Nqfj-_NAT1Yqj5lXOdxhjJah62Rwx2UqqqDxu7q-c89bYCUWH_FCS2Zhsx2ASCr78iCX5dZ7Q6c235VmdIxtTHEyaUC4wxOwz2lYMZdhAAmRNsH7nKz4OH9Al6sdQvIWhQEJ5qjt9HVmUYONhi8zQoR6K-f3rwQwmTFX3unnhTMjw5lBPmq-frr4sPs-Wt9c3i8vlzLJWilm7YlQJIanjrFOMceM4Addxa6k0plO0PhEIXhkuwWEuBJ-TlVNGkdap1rGT5nTvXaf4c4RcdO-zhRDMAHHMmqq6IKTEpKLv_0Pv4pjqvVkzzOZcSMF21NmesinmnMDpdfJ9_SlNsN6lpGtK-jGlyr47GMdVD90_8m8sFbjYA1sfYHrapBeLj3vlH8plnnE</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Sagris, Marios</creator><creator>Ktenopoulos, Nikolaos</creator><creator>Dimitriadis, Kyriakos</creator><creator>Papanikolaou, Angelos</creator><creator>Tzoumas, Andreas</creator><creator>Terentes‐Printzios, Dimitrios</creator><creator>Synetos, Andreas</creator><creator>Soulaidopoulos, Stergios</creator><creator>Lichtenberg, Michael</creator><creator>Korosoglou, Grigorios</creator><creator>Honton, Benjamin</creator><creator>Tousoulis, Dimitris</creator><creator>Tsioufis, Costas</creator><creator>Toutouzas, Konstantinos</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8516-1177</orcidid><orcidid>https://orcid.org/0000-0002-3473-1368</orcidid><orcidid>https://orcid.org/0000-0003-4039-8263</orcidid><orcidid>https://orcid.org/0000-0003-3186-8905</orcidid><orcidid>https://orcid.org/0000-0002-6038-2253</orcidid><orcidid>https://orcid.org/0000-0002-0995-7015</orcidid><orcidid>https://orcid.org/0000-0003-2946-344X</orcidid></search><sort><creationdate>20240401</creationdate><title>Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with severe calcification: A multicenter systematic review and meta‐analysis</title><author>Sagris, Marios ; Ktenopoulos, Nikolaos ; Dimitriadis, Kyriakos ; Papanikolaou, Angelos ; Tzoumas, Andreas ; Terentes‐Printzios, Dimitrios ; Synetos, Andreas ; Soulaidopoulos, Stergios ; Lichtenberg, Michael ; Korosoglou, Grigorios ; Honton, Benjamin ; Tousoulis, Dimitris ; Tsioufis, Costas ; Toutouzas, Konstantinos</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3486-4b3296682f53d9335af51efd5cc28aad92384e10ba58ef0566571bf9a914f94f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Calcification</topic><topic>Calcification (ectopic)</topic><topic>Calcium signalling</topic><topic>complications</topic><topic>coronary arteries</topic><topic>Coronary artery</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - mortality</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary Stenosis - diagnostic imaging</topic><topic>Coronary Stenosis - therapy</topic><topic>Coronary vessels</topic><topic>efficacy</topic><topic>Female</topic><topic>Humans</topic><topic>Implants</topic><topic>intravascular lithotripsy</topic><topic>Lesions</topic><topic>Lithotripsy</topic><topic>Lithotripsy - adverse effects</topic><topic>major adverse events</topic><topic>Male</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>Multicenter Studies as Topic</topic><topic>Myocardial infarction</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - instrumentation</topic><topic>Percutaneous Coronary Intervention - mortality</topic><topic>Restenosis</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>safety</topic><topic>Severity of Illness Index</topic><topic>Stents</topic><topic>success</topic><topic>Thrombosis</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vascular Calcification - diagnostic imaging</topic><topic>Vascular Calcification - mortality</topic><topic>Vascular Calcification - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sagris, Marios</creatorcontrib><creatorcontrib>Ktenopoulos, Nikolaos</creatorcontrib><creatorcontrib>Dimitriadis, Kyriakos</creatorcontrib><creatorcontrib>Papanikolaou, Angelos</creatorcontrib><creatorcontrib>Tzoumas, Andreas</creatorcontrib><creatorcontrib>Terentes‐Printzios, Dimitrios</creatorcontrib><creatorcontrib>Synetos, Andreas</creatorcontrib><creatorcontrib>Soulaidopoulos, Stergios</creatorcontrib><creatorcontrib>Lichtenberg, Michael</creatorcontrib><creatorcontrib>Korosoglou, Grigorios</creatorcontrib><creatorcontrib>Honton, Benjamin</creatorcontrib><creatorcontrib>Tousoulis, Dimitris</creatorcontrib><creatorcontrib>Tsioufis, Costas</creatorcontrib><creatorcontrib>Toutouzas, Konstantinos</creatorcontrib><collection>Wiley-Blackwell Open Access Titles</collection><collection>Wiley Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sagris, Marios</au><au>Ktenopoulos, Nikolaos</au><au>Dimitriadis, Kyriakos</au><au>Papanikolaou, Angelos</au><au>Tzoumas, Andreas</au><au>Terentes‐Printzios, Dimitrios</au><au>Synetos, Andreas</au><au>Soulaidopoulos, Stergios</au><au>Lichtenberg, Michael</au><au>Korosoglou, Grigorios</au><au>Honton, Benjamin</au><au>Tousoulis, Dimitris</au><au>Tsioufis, Costas</au><au>Toutouzas, Konstantinos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with severe calcification: A multicenter systematic review and meta‐analysis</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2024-04-01</date><risdate>2024</risdate><volume>103</volume><issue>5</issue><spage>710</spage><epage>721</epage><pages>710-721</pages><issn>1522-1946</issn><issn>1522-726X</issn><eissn>1522-726X</eissn><abstract>Background
With heavily calcified coronary and peripheral artery lesions, lesion preparation is crucial before stent placement to avoid underexpansion, associated with stent thrombosis or restenosis and patency failure in the long‐term. Intravascular lithotripsy (IVL) technology disrupts superficial and deep calcium by using localized pulsative sonic pressure waves, making it to a promising tool for patients with severe calcification in coronary bed.
Aims
The aim of the study is to systematically review and summarize available data regarding the safety and efficacy of IVL for lesion preparation in severely calcified coronary arteries before stenting.
Methods
This study was conducted according to the PRISMA guidelines. We systematically searched PubMed, SCOPUS, and Cochrane databases from their inception to February 23, 2023, for studies assessing the characteristics and outcomes of patients undergoing IVL before stent implantation. The diameter of the vessel lumen before and after IVL, as well as stent implantation, were analyzed. The occurrence of major adverse cardiovascular events (MACE) was assessed using a random‐effects model.
Results
This meta‐analysis comprised 38 studies including 2977 patients with heavily calcified coronary lesions. The mean age was 72.2 ± 9.1 years, with an overall IVL clinical success of 93% (95% confidence interval [CI]: 91%−95%, I2 = 0%) and procedural success rate of 97% (95% CI: 95%−98%, I2 = 73.7%), while the in‐hospital and 30‐days incidence of MACE, myocardial infarction (MI), and death were 8% (95% CI: 6%−11%, I2 = 84.5%), 5% (95% CI: 2%−8%, I2 = 85.6%), and 2% (95% CI: 1%−3%, I2 = 69.3%), respectively. There was a significant increase in the vessel diameter (standardized mean difference [SMD]: 2.47, 95% CI: 1.77−3.17, I2 = 96%) and a decrease in diameter stenosis (SMD: −3.44, 95% CI: −4.36 to −2.52, I2 = 97.5%) immediately after IVL application, while it was observed further reduction in diameter stenosis (SMD: −6.57, 95% CI: −7.43 to −5.72, I2 = 95.8%) and increase in the vessel diameter (SMD: 4.37, 95% CI: 3.63−5.12, I2 = 96.7%) and the calculated lumen area (SMD: 3.23, 95% CI: 2.10−4.37, I2 = 98%), after stent implantation. The mean acute luminal gain following IVL and stent implantation was estimated to be 1.27 ± 0.6 and 1.94 ± 1.1 mm, respectively. Periprocedural complications were rare, with just a few cases of perforations, dissection, or no‐reflow phenomena recorded.
Conclusions
IVL seems to be a safe and effective strategy for lesion preparation in severely calcified lesions before stent implantation in coronary arteries. Future prospective studies are now warranted to compare IVL to other lesion preparation strategies.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38482928</pmid><doi>10.1002/ccd.31006</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-8516-1177</orcidid><orcidid>https://orcid.org/0000-0002-3473-1368</orcidid><orcidid>https://orcid.org/0000-0003-4039-8263</orcidid><orcidid>https://orcid.org/0000-0003-3186-8905</orcidid><orcidid>https://orcid.org/0000-0002-6038-2253</orcidid><orcidid>https://orcid.org/0000-0002-0995-7015</orcidid><orcidid>https://orcid.org/0000-0003-2946-344X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1522-1946 |
| ispartof | Catheterization and cardiovascular interventions, 2024-04, Vol.103 (5), p.710-721 |
| issn | 1522-1946 1522-726X 1522-726X |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2957168801 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Aged, 80 and over Calcification Calcification (ectopic) Calcium signalling complications coronary arteries Coronary artery Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - mortality Coronary Artery Disease - therapy Coronary Stenosis - diagnostic imaging Coronary Stenosis - therapy Coronary vessels efficacy Female Humans Implants intravascular lithotripsy Lesions Lithotripsy Lithotripsy - adverse effects major adverse events Male Meta-analysis Middle Aged Multicenter Studies as Topic Myocardial infarction Patients Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - instrumentation Percutaneous Coronary Intervention - mortality Restenosis Risk Assessment Risk Factors safety Severity of Illness Index Stents success Thrombosis Time Factors Treatment Outcome Vascular Calcification - diagnostic imaging Vascular Calcification - mortality Vascular Calcification - therapy |
| title | Efficacy of intravascular lithotripsy (IVL) in coronary stenosis with severe calcification: A multicenter systematic review and meta‐analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-15T11%3A14%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Efficacy%20of%20intravascular%20lithotripsy%20(IVL)%20in%20coronary%20stenosis%20with%20severe%20calcification:%20A%20multicenter%20systematic%20review%20and%20meta%E2%80%90analysis&rft.jtitle=Catheterization%20and%20cardiovascular%20interventions&rft.au=Sagris,%20Marios&rft.date=2024-04-01&rft.volume=103&rft.issue=5&rft.spage=710&rft.epage=721&rft.pages=710-721&rft.issn=1522-1946&rft.eissn=1522-726X&rft_id=info:doi/10.1002/ccd.31006&rft_dat=%3Cproquest_cross%3E2957168801%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=3037568631&rft_id=info:pmid/38482928&rfr_iscdi=true |