Department of Cardiology, St James's Hospital, Dublin, D08 NHY1, Ireland.
Ir J Med Sci. 2023 Jun;192(3):1085-1090. doi: 10.1007/s11845-022-03077-9. Epub 2022 Jul 9.
Despite the increased uptake of intravascular lithotripsy (IVL) for treating severely calcified coronary lesions, there is limited patient-level data examining the effect of IVL on quality of life, symptomatology, and outcomes beyond 30 days. We sought to assess demographics, procedural characteristics, outcomes, and impact of IVL on patient-reported angina after a minimum of 6 months follow-up.
A retrospective single-center study was conducted of patients treated with coronary IVL between January and October 2020. Baseline demographics were obtained from electronic patient records and SYNTAX scores were calculated from index coronary angiograms. Technical success and complications were assessed along with clinical outcomes, which included all-cause mortality, myocardial infarction (MI), target lesion revascularization (TLR), and MACE (composite of death, stroke, MI, and TLR). Canadian Cardiovascular Society (CCS) angina classification was assessed at virtual clinical follow-up.
Forty-seven consecutive patients were included. At a mean follow-up of 306 ± 74 days, the mean CCS angina score was reduced by 53% post-IVL-assisted PCI (2.9 vs 1.4, p < 0.001). Technical and procedural success were high (94% and 92%, respectively). One patient (2%) met the pre-specified criteria for in-hospital MACE and 4 (9%) met pre-specified MACE at follow-up, including 2 deaths and 2 TLR. Procedural complications included coronary dissection (11%) and coronary perforation (6%) and were managed either conservatively or with PCI.
Coronary IVL is a safe and effective adjunctive therapy for treating heavily calcified coronary lesions. This cohort shows high procedural success and a significant reduction in CCS angina at follow-up.
尽管腔内碎石术（IVL）在治疗严重钙化的冠状动脉病变方面的应用越来越多，但对于 IVL 对生活质量、症状和 30 天后结局的影响，仅有有限的患者水平数据进行了检查。我们旨在评估接受冠状动脉 IVL 治疗的患者的人口统计学、程序特征、结局以及 IVL 对至少 6 个月随访后患者报告的心绞痛的影响。
对 2020 年 1 月至 10 月期间接受冠状动脉 IVL 治疗的患者进行回顾性单中心研究。从电子患者记录中获取基线人口统计学数据，并从指数冠状动脉造影中计算 SYNTAX 评分。评估技术成功率和并发症以及临床结局，包括全因死亡率、心肌梗死（MI）、靶病变血运重建（TLR）和 MACE（死亡、中风、MI 和 TLR 的复合事件）。在虚拟临床随访时评估加拿大心血管学会（CCS）心绞痛分级。
共纳入 47 例连续患者。在平均 306±74 天的随访中，IVL 辅助 PCI 后 CCS 心绞痛评分降低了 53%（2.9 分 vs 1.4 分，p<0.001）。技术和程序成功率均很高（分别为 94%和 92%）。1 例患者（2%）符合住院期间 MACE 的预设标准，4 例患者（9%）在随访时符合预设的 MACE，包括 2 例死亡和 2 例 TLR。程序并发症包括冠状动脉夹层（11%）和冠状动脉穿孔（6%），均通过保守或 PCI 进行治疗。
冠状动脉 IVL 是治疗严重钙化冠状动脉病变的一种安全有效的辅助治疗方法。该队列显示出高的程序成功率和随访时 CCS 心绞痛显著降低。
