Impact of coronary calcium morphology on intravascular lithotripsy
Angela McInerney, Alejandro Travieso, Adrián Jerónimo Baza, Fernándo Alfonso, David Del Val, Enrico Cerrato, Juan García de Lara, Eduardo Pinar, Armando Pérez de Prado, Pilar Jiménez Quevedo, Gabriela Tirado‐Conte, Luis Nombela‐Franco, Salvatore Brugaletta, Pedro Cepas‐Guillén, Manel Sabaté, Héctor Cubero Gallego, Beatriz Vaquerizo, Alfonso Jurado, Ferdinando Varbella, Marcelo Jiménez, Artemio Garcia Escobar, José María de la Torre, Ignacio J. Amat‐Santos, Víctor Alfonso Jiménez Díaz, Javier Escaned, Nieves Gonzalo
Abstract
BACKGROUND: Coronary calcification negatively impacts optimal stenting. Intravascular lithotripsy (IVL) is a new calcium modification technique. AIMS: We aimed to assess the impact of different calcium morphologies on IVL efficacy. METHODS: This was a prospective, multicentre study (13 tertiary referral centres). Optical coherence tomography (OCT) was performed before and after IVL, and after stenting. OCT-defined calcium morphologies were concentric (mean calcium arc >180°) and eccentric (mean calcium arc ≤180°). The primary outcomes were angiographic success (residual stenosis <20%) and the presence of fracture by OCT in concentric versus eccentric lesions. RESULTS: ; p=0.483), minimum stent expansion (80.9±16.7% vs 78.2±19.8%), or stent expansion at the maximum calcium site (100.6±24.2% vs 95.8±27.3%) (p>0.05 for all comparisons of concentric vs eccentric, respectively). Calcified nodules were found in 29.5% of lesions; these were predominantly non-eruptive (57%). At the nodule site, dissection was more common than fracture with stent expansion of 103.6±27.2%. CONCLUSIONS: In this prospective, multicentre study, the effectiveness of IVL followed by stenting was not significantly affected by coronary calcium morphology.