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

Piotr Rola, Jan Jakub Kulczycki, Adrian Włodarczak, Mateusz Barycki, Szymon Włodarczak, Marek Szudrowicz, Łukasz Furtan, Artur Jastrzębski, Maciej Pęcherzewski, Maciej Lesiak and Adrian Doroszko
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Piotr Rola: Faculty of Health Sciences and Physical Culture, Witelon Collegium State University, 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
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

IJERPH, 2022, vol. 19, issue 15, 1-12

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.

Keywords: left main; rotational atherectomy; intravascular lithotripsy; high-risk percutaneous coronary intervention; percutaneous coronary intervention (PCI); vascular disease; coronary artery diseases (CAD); cardiovascular diseases; shock wave intravascular lithotripsy device (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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