Intravascular Lithotripsy for the Treatment of Calcium-Mediated Coronary In-Stent Restenoses
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Intravascular Lithotripsy for the Treatment of Calcium-Mediated Coronary In-Stent Restenoses. / Brunner, Fabian J; Becher, Peter Moritz; Waldeyer, Christoph; Zengin-Sahm, Elvin; Schnabel, Renate B; Clemmensen, Peter; Westermann, Dirk; Blankenberg, Stefan; Seiffert, Moritz.
in: J INVASIVE CARDIOL, Jahrgang 33, Nr. 1, 01.2021, S. E25-E31.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Intravascular Lithotripsy for the Treatment of Calcium-Mediated Coronary In-Stent Restenoses
AU - Brunner, Fabian J
AU - Becher, Peter Moritz
AU - Waldeyer, Christoph
AU - Zengin-Sahm, Elvin
AU - Schnabel, Renate B
AU - Clemmensen, Peter
AU - Westermann, Dirk
AU - Blankenberg, Stefan
AU - Seiffert, Moritz
PY - 2021/1
Y1 - 2021/1
N2 - BACKGROUND: Coronary intravascular lithotripsy (IVL) has recently been evaluated for the treatment of severely calcified native coronary lesions. Evidence for its use in in-stent restenosis is sparse and is still an off-label indication. Therefore, we aimed to evaluate the feasibility, safety, and acute and mid-term angiographic outcomes after IVL for the treatment of calcium-mediated coronary in-stent restenosis.METHODS: A retrospective, single-center analysis was performed for 6 cases with undilatable instent restenosis due to calcium-mediated stent underexpansion and/ or calcified neointima from January to November 2019. Lesions were treated with IVL (Shockwave Medical) and subsequent drug-eluting stent or drug-coated balloon. Angiographic success was defined as residual lumen stenosis <20% and Thrombolysis in Myocardial Infarction 3 flow. Follow-up angiography was performed at a median of 141.5 days.RESULTS: Six patients presented with symptomatic in-stent restenoses (65.8% to 87.9%) at 11 to 175 months after implantation. Intravascular and angiographic imaging detected calcium-mediated stent underexpansion (n = 2), calcified neointima (n = 2), or a combination of both (n = 2) as cause of restenosis. In-stent IVL, subsequent high-pressure balloon dilation, and drug-eluting stent or drug-coated balloon implantation were performed successfully in all cases. Acute angiographic success and angina relief were achieved in 5 of 6 cases and sustained during follow-up. No major acute cardiovascular events occurred.CONCLUSIONS: The application of IVL for the treatment of calcium-mediated coronary in-stent restenosis was feasible and safe, and yielded promising short- and mid-term results in the majority of cases.
AB - BACKGROUND: Coronary intravascular lithotripsy (IVL) has recently been evaluated for the treatment of severely calcified native coronary lesions. Evidence for its use in in-stent restenosis is sparse and is still an off-label indication. Therefore, we aimed to evaluate the feasibility, safety, and acute and mid-term angiographic outcomes after IVL for the treatment of calcium-mediated coronary in-stent restenosis.METHODS: A retrospective, single-center analysis was performed for 6 cases with undilatable instent restenosis due to calcium-mediated stent underexpansion and/ or calcified neointima from January to November 2019. Lesions were treated with IVL (Shockwave Medical) and subsequent drug-eluting stent or drug-coated balloon. Angiographic success was defined as residual lumen stenosis <20% and Thrombolysis in Myocardial Infarction 3 flow. Follow-up angiography was performed at a median of 141.5 days.RESULTS: Six patients presented with symptomatic in-stent restenoses (65.8% to 87.9%) at 11 to 175 months after implantation. Intravascular and angiographic imaging detected calcium-mediated stent underexpansion (n = 2), calcified neointima (n = 2), or a combination of both (n = 2) as cause of restenosis. In-stent IVL, subsequent high-pressure balloon dilation, and drug-eluting stent or drug-coated balloon implantation were performed successfully in all cases. Acute angiographic success and angina relief were achieved in 5 of 6 cases and sustained during follow-up. No major acute cardiovascular events occurred.CONCLUSIONS: The application of IVL for the treatment of calcium-mediated coronary in-stent restenosis was feasible and safe, and yielded promising short- and mid-term results in the majority of cases.
KW - Calcium
KW - Coronary Angiography
KW - Coronary Restenosis/diagnosis
KW - Drug-Eluting Stents/adverse effects
KW - Humans
KW - Lithotripsy
KW - Retrospective Studies
KW - Treatment Outcome
UR - https://www.hmpgloballearningnetwork.com/site/jic/articles/intravascular-lithotripsy-treatment-calcium-mediated-coronary-stent-restenoses
U2 - 10.25270/jic/20.00285
DO - 10.25270/jic/20.00285
M3 - SCORING: Journal article
C2 - 33385983
VL - 33
SP - E25-E31
JO - J INVASIVE CARDIOL
JF - J INVASIVE CARDIOL
SN - 1042-3931
IS - 1
ER -