Intravascular Lithotripsy for Acute Stent Under-Expansion and In-Stent Restenosis: A Case Series

Thandra, Abhishek; Betts, Lucas; Aggarwal, Gaurav; Gujjula, Nagarjuna; Haddad, Toufik Mahfood

doi:10.1016/j.cpcardiol.2022.101511

Cited by 5 publications

(2 citation statements)

References 17 publications

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“…The mean follow‐up time was 200 days, and none of the seven patients experienced operation‐related complications or adverse cardiovascular events. The result confirmed that IVL could be used in patients with intrastent restenosis, further expanding the using range of IVL 19 . It is worth mentioning that the effectiveness of IVL in multilayer stents has not been proven 1 …”

Section: Coronary Intravascular Lithotripsy Systemmentioning

confidence: 54%

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Intravascular lithotripsy: A novel option for severe calcification of coronary artery

Lv,

Li,

Ren

et al. 2023

Clinical Cardiology

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BackgroundSevere coronary artery calcification is associated with low success rate of interventional operation, perioperative adverse cardiac events, and poor prognosis, which is a major problem faced by operators. The existing therapy methods all have inherent limitations, such as unsatisfactory balloon crossability, inadequate balloon dilation, and so on. The emergence of intravascular lithotripsy (IVL) has brought the dawn of the treatment of calcified lesions by using unfocused acoustic pressure waves to fracture calcification in situ. And IVL is the only technology capable of targeting deep calcification.HypothesisIVL may have great clinical application values and potential prospects.MethodBased on the existing clinical evidence of IVL and traditional treatment ways, this review discusses the safety and efficacy of IVL. Combined with clinical practice, the precautions and coping strategies of IVL are analyzed. And the review improves the management algorithm of coronary calcification.ResultsIVL has extremely high safety and effectiveness for severe coronary calcification compared with other ways, and structural improvements of IVL will further expand its value.ConclusionsThe emergence of IVL could set off a revolution in the treatment of coronary artery calcification.

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Section: Coronary Intravascular Lithotripsy Systemmentioning

confidence: 54%

“…The result confirmed that IVL could be used in patients with intrastent restenosis, further expanding the using range of IVL. 19 It is worth mentioning that the effectiveness of IVL in multilayer stents has not been proven. 1 indicates the presence of dissection at the lesion site.…”

Section: Operation Processmentioning

confidence: 99%

Intravascular lithotripsy: A novel option for severe calcification of coronary artery

Lv,

Li,

Ren

et al. 2023

Clinical Cardiology

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Procedural and clinical impact of intravascular lithotripsy for the treatment of peri-stent calcification

van Oort,

Al Amri,

Bingen

et al. 2024

Cardiovascular Revascularization Medicine

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Successful intravascular lithotripsy after all other options failed with stent under-expansion: a case report and review of alternative options

Breitbart,

Billig,

Schöfthaler

et al. 2024

European Heart Journal - Case Reports

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Structured Abstract Background Stent under-expansion, often caused by severe circumferential coronary calcification, must be prevented as it increases the risk of neoatherosclerosis and stent thrombosis. Intravascular lithotripsy (IVL) is an effective lesion preparation strategy to enable sufficient expansion of a stent that was initially not sufficiently expanded. Case summary A 62-year-old male patient presented in our emergency department due to unstable angina. Coronary angiography revealed 1-vessel coronary artery disease with high grade stenosis of the proximal to mid right coronary artery. Direct implantation of a drug-eluting-stent was performed. However, stent under-expansion was noticed. Post-dilatation with semi-compliant ballon up to 24bar was unsuccessful. Subsequent dilatation with an ultra-high pressure OPN non-compliant balloon at 50bar resulted to balloon rupture but stent under-expansion remained. Therefore, IVL was performed, resulting in complete stent expansion already at 4bar. The patient was put on dual platelet treatment and his further clinical course was uneventful after 6 months of follow-up. Discussion The present case report highlights the role of IVL as a safe and effective treatment option in case of immediate stent under-expansion. This has significant implications on daily practice as under-expansion may lead to high rates of in-stent restenosis and stent thrombosis. Furthermore, this case report underlines the impact of lesion preparation, even in presumably less complex lesion by angiographic criteria.

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Intravascular Lithotripsy for Acute Stent Under-Expansion and In-Stent Restenosis: A Case Series

Cited by 5 publications

References 17 publications

Intravascular lithotripsy: A novel option for severe calcification of coronary artery

Intravascular lithotripsy: A novel option for severe calcification of coronary artery

Procedural and clinical impact of intravascular lithotripsy for the treatment of peri-stent calcification

Successful intravascular lithotripsy after all other options failed with stent under-expansion: a case report and review of alternative options

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