Claudia Cosgrove1, Colm G Hanratty2, Jonathan M Hill3, Kalaivani Mahadevan4, Jonathan Mailey5, Margaret McEntegart6, Peter O'Kane7, Novalia Sidik6, Julian W Strange4, Simon J Walsh5, Simon Wilson1, Julian Yeoh8, James C Spratt1. 1. Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London, UK. 2. Department of Cardiology, Mater Private Hospital, Dublin, UK. 3. Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK. 4. Department of Cardiology, Bristol Heart Institute, Bristol, UK. 5. Department of Cardiology, Belfast Health and Social Care Trust, Belfast, UK. 6. Department of Cardiology, Golden Jubilee Hospital, Clydebank, UK. 7. Department of Cardiology, Royal Bournemouth Hospital, Bournemouth, UK. 8. Department of Cardiology, Kings College Hospital NHS Foundation Trust, London, UK.
Abstract
AIMS: To describe the utility and safety of intravascular lithotripsy (IVL) in the setting of primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI). METHODS AND RESULTS: We performed a retrospective analysis, across six UK sites of all patients in whom IVL was used for coronary calcium modification of the culprit lesion during primary PCI for STEMI. The 72 patients were included. IVL was used in de-novo culprit lesions in 57 (79%) of cases and culprit in-stent restenoses in 11 (15%) of cases. In four cases (6%) it was used in a newly deployed stent when this was under-expanded due to inadequate calcium modification. Of the 30 cases in which intracoronary imaging was available for stent analysis, the average stent expansion was 104%. Intra-procedural stent thrombosis occurred in one case (1%), and no-reflow in three cases (4%). The 30 day MACE rates were 18%. CONCLUSION: IVL appears to be feasible and safe for use in the treatment of calcific coronary artery disease in the setting of STEMI.
AIMS: To describe the utility and safety of intravascular lithotripsy (IVL) in the setting of primary percutaneous coronary intervention (PCI) for ST elevation myocardial infarction (STEMI). METHODS AND RESULTS: We performed a retrospective analysis, across six UK sites of all patients in whom IVL was used for coronary calcium modification of the culprit lesion during primary PCI for STEMI. The 72 patients were included. IVL was used in de-novo culprit lesions in 57 (79%) of cases and culprit in-stent restenoses in 11 (15%) of cases. In four cases (6%) it was used in a newly deployed stent when this was under-expanded due to inadequate calcium modification. Of the 30 cases in which intracoronary imaging was available for stent analysis, the average stent expansion was 104%. Intra-procedural stent thrombosis occurred in one case (1%), and no-reflow in three cases (4%). The 30 day MACE rates were 18%. CONCLUSION: IVL appears to be feasible and safe for use in the treatment of calcific coronary artery disease in the setting of STEMI.