Department of Cardiology, The People's Hospital of China Medical University, Shenyang City, Liaoning Province, People's Republic of China.
Department of Cardiology, Jinzhou Medical University, Jinzhou City, Liaoning Province, People's Republic of China.
Clin Cardiol. 2024 Feb;47(2):e24186. doi: 10.1002/clc.24186. Epub 2023 Nov 9.
Severe coronary artery calcification is associated with low success rate of interventional operation, perioperative adverse cardiac events, and poor prognosis, which is a major problem faced by operators. The existing therapy methods all have inherent limitations, such as unsatisfactory balloon crossability, inadequate balloon dilation, and so on. The emergence of intravascular lithotripsy (IVL) has brought the dawn of the treatment of calcified lesions by using unfocused acoustic pressure waves to fracture calcification in situ. And IVL is the only technology capable of targeting deep calcification.
IVL may have great clinical application values and potential prospects.
Based on the existing clinical evidence of IVL and traditional treatment ways, this review discusses the safety and efficacy of IVL. Combined with clinical practice, the precautions and coping strategies of IVL are analyzed. And the review improves the management algorithm of coronary calcification.
IVL has extremely high safety and effectiveness for severe coronary calcification compared with other ways, and structural improvements of IVL will further expand its value.
The emergence of IVL could set off a revolution in the treatment of coronary artery calcification.
严重的冠状动脉钙化与介入手术成功率低、围手术期心脏不良事件和预后不良有关，这是操作者面临的主要问题。现有的治疗方法都存在固有局限性，如球囊可通过性不理想、球囊扩张不足等。血管内碎石术（IVL）的出现为使用非聚焦声压波原位断裂钙化带来了治疗钙化病变的曙光。而且 IVL 是唯一能够靶向深层钙化的技术。
IVL 可能具有巨大的临床应用价值和潜在前景。
基于 IVL 和传统治疗方法的现有临床证据，本文综述了 IVL 的安全性和有效性。结合临床实践，分析了 IVL 的注意事项和应对策略。该综述改进了冠状动脉钙化的管理算法。
与其他方法相比，IVL 治疗严重冠状动脉钙化具有极高的安全性和有效性，IVL 的结构改进将进一步扩大其价值。
IVL 的出现可能引发冠状动脉钙化治疗的革命。
