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Intravascular Lithotripsy as a Novel Treatment Method for Calcified Unprotected Left Main Diseases—Comparison to Rotational Atherectomy—Short-Term Outcomes

Author

Listed:
  • Piotr Rola

    (Faculty of Health Sciences and Physical Culture, Witelon Collegium State University, 59-220 Legnica, Poland
    Department of Cardiology, Provincial Specialized Hospital, 59-220 Legnica, Poland)

  • Jan Jakub Kulczycki

    (Department of Cardiology, The Copper Health Centre (MCZ), 59-300 Lubin, Poland)

  • Adrian Włodarczak

    (Faculty of Health Sciences and Physical Culture, Witelon Collegium State University, 59-220 Legnica, Poland
    Department of Cardiology, The Copper Health Centre (MCZ), 59-300 Lubin, Poland)

  • Mateusz Barycki

    (Department of Cardiology, Provincial Specialized Hospital, 59-220 Legnica, Poland)

  • Szymon Włodarczak

    (Department of Cardiology, The Copper Health Centre (MCZ), 59-300 Lubin, Poland)

  • Marek Szudrowicz

    (Department of Cardiology, The Copper Health Centre (MCZ), 59-300 Lubin, Poland)

  • Łukasz Furtan

    (Department of Cardiology, Provincial Specialized Hospital, 59-220 Legnica, Poland)

  • Artur Jastrzębski

    (Department of Cardiology, The Copper Health Centre (MCZ), 59-300 Lubin, Poland)

  • Maciej Pęcherzewski

    (Department of Cardiology, The Copper Health Centre (MCZ), 59-300 Lubin, Poland)

  • Maciej Lesiak

    (1st Department of Cardiology, University of Medical Sciences, 61-848 Poznan, Poland)

  • Adrian Doroszko

    (Clinical Department of Internal Medicine and Occupational Diseases, Hypertension and Clinical Oncology, Faculty of Medicine, Wroclaw Medical University, 50-556 Wroclaw, Poland)

Abstract

Background: The unprotected calcified Left Main disease represents a high-risk subset for percutaneous coronary intervention (PCI), and it is associated with a higher number of periprocedural complications and an increased rate of in-stent thrombosis and restenosis. Adequate lesion preparation plays a crucial role in achieving a favorable PCI outcome. Rotational Atherectomy (RA) is a well-established plaque-modifying method; nevertheless, the data regarding the effectiveness of RA in LM diseases is scarce. Recently, the novel ShockWave-Intravascular-Lithotripsy(S-IVL) device has been introduced to the PCI armamentarium in order to modify the calcified plaque. Methods: We performed a retrospective evaluation of 44 consecutive subjects who underwent the LM-PCI, and who were supported by either the RA or S-IVL. Results: The Rota group consisted of 29 patients with a mean syntax score of 28.0 ± 7.5. The S-IVL group was composed of 15 subjects with a syntax score of 23.3 ± 13.0 There were no statistical differences regarding MACE between the RA and Shockwave arms of the in-hospital group (10.3% vs. 6.7%), or in the six month (17.2% vs. 13.3%) follow-up group. Conclusions: RA and S-IVL could be safe and effective therapeutic strategies for calcified LM disease. Further studies with a higher number of participants and longer follow-up times are warranted to establish the potential benefits of RA and S-IVL for the management of LM stenosis.

Suggested Citation

  • Piotr Rola & Jan Jakub Kulczycki & Adrian Włodarczak & Mateusz Barycki & Szymon Włodarczak & Marek Szudrowicz & Łukasz Furtan & Artur Jastrzębski & Maciej Pęcherzewski & Maciej Lesiak & Adrian Doroszk, 2022. "Intravascular Lithotripsy as a Novel Treatment Method for Calcified Unprotected Left Main Diseases—Comparison to Rotational Atherectomy—Short-Term Outcomes," IJERPH, MDPI, vol. 19(15), pages 1-12, July.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9011-:d:870687
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    References listed on IDEAS

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    1. Grzegorz K. Jakubiak & Natalia Pawlas & Grzegorz Cieślar & Agata Stanek, 2021. "Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes," IJERPH, MDPI, vol. 18(22), pages 1-23, November.
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