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REAL-WORLD DATA FROM A MULTICENTER REGISTRY OF CORONARY LITHOTRIPSY FOR TREATMENT OF CALCIFIED CORONARY LESIONS

Journal of the American College of Cardiology(2020)

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摘要
Introduction and objectives: Coronary lithoplasty (CL) is a balloon-based technique used to treat calcified lesions. This study reports the initial experience o f treatment of calcified lesions w ith CL in an unselected and high-risk population. Methods: This was a prospective, multicenter registry, which included all consecutive cases with calcified coronary lesions that underwent CL between August, 2018 and August, 2019. Exclusion criteria consisted of a target lesion located in a small vessel (< 2.5 m m ) and the presence of dissection prior to CL. Quantitative coronary angiography and intravascular ultrasound/optical coherence tom ography analysis w ere com pleted by an independent central core laboratory. Results: This registry included 57 patients (66 lesions). The population w as elderly (72.6 +/- 9.4 years) with high proportions of patients with diabetes (56%), chronic kidney disease (35%), and multivessel disease (84%). All lesions were classified as type B/C. More than 75% of lesions were predilated with noncompliant/ semicompliant balloons or cutting-balloon. Rotablator was used in 5 lesions (7.6%) prelithoplasty. On average, CL required 1.17 balloons delivering a mean of 60 pulses. Successful CL was achieved in 98%. In 13% of cases, lithoplasty balloon was broken during therapy. There were few procedural complications: 2 cases of significant dissections (none related to lithoplasty balloon rupture) were successfully treated with drugeluting stent implantation. One patient experienced stent thrombosis 2 days after successfully undergoing target lesion revascularization. Conclusions: This is a real-world multicenter registry, which supports the feasibility, safety, and short-term efficacy of PCI for calcified coronary lesions using CL in an unselected and high-risk population with promising results. (C) 2020 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cardiologia.
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关键词
Coronary lithoplasty,Coronary lithotripsy,Lithoplasty balloon,Coronary calcified lesions,Plaque-modification devices
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