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Clinical and angiographic success and safety comparison of coronary intravascular lithotripsy: An updated meta-analysis

Mamas

Clinical and angiographic success and safety comparison of coronary intravascular lithotripsy: An updated meta-analysis Thumbnail


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Abstract

Background
Intravascular lithotripsy (IVL) can be used to assist stent deployment in severe coronary artery calcifications (CAC).

Methods
Studies employing IVL for CAC lesions were included. The primary outcomes included clinical and angiographic success. The secondary outcomes, including lumen gain, maximum calcium thickness, and calcium angle at the final angiography site, minimal lumen area site, and minimal stent area site, were analyzed by the random-effects model to calculate the pooled standardized mean difference. Tertiary outcomes included safety event ratios.

Results
Seven studies (760 patients) were included. The primary outcomes: pooled clinical and angiographic success event ratio parentage of IVL was 94.4% and 94.8%, respectively. On a random effect model for standard inverse variance for secondary outcomes showed: minimal lumen diameter increase with IVL was 4.68 mm (p-value < 0.0001, 95% CI 1.69–5.32); diameter decrease in the stenotic area after IVL session was -5.23 mm (95 CI –22.6–12.8). At the minimal lumen area (MLA) and final minimal stent area (MSA) sites, mean lumen area gain was 1.42 mm2 (95% CI 1.06–1.63; p < 0.00001) and 1.34 mm2 (95% CI 0.71–1.43; p < 0.00001), respectively. IVL reduced calcium thickness at the MLA site (SMD -0.22; 95% CI -0.40–0.04; P = 0.02); calcium angle was not affected at the MLA site. The tertiary outcomes: most common complication was major adverse cardiovascular events (n = 48/669), and least common complication was abrupt closure of the vessel (n = 1/669).

Conclusions
Evidence suggests that IVL safely and effectively facilitates stent deployment with high angiographic and clinical success rates in treating severely calcified coronary lesions.

Acceptance Date Feb 12, 2022
Publication Date Apr 1, 2022
Publicly Available Date Mar 29, 2024
Journal IJC Heart &amp; Vasculature
Print ISSN 2352-9067
Pages 100975 - 100975
DOI https://doi.org/10.1016/j.ijcha.2022.100975
Keywords IVL; Intravascular lithotripsy; Coronary artery calcification
Publisher URL https://www.sciencedirect.com/science/article/pii/S2352906722000240?via%3Dihub

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