Intracoronary Lithotripsy Use for In-Stent Restenosis, Including Multilayer ISR.

Introduction: Intravascular lithotripsy (IVL) has been well characterized as a safe and effective method for plaque modification in the treatment of de-novo, calcific coronary artery disease. In-stent restenosis (ISR) remains a major challenge in coronary revascularization, especially "multilayer" I...

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Publicado en:Cardiovascular Revascularization Medicine Vol. 44; pp. 10 - 14
Autores principales: Kassab, Kameel, Kassier, Adnan, Fischell, Tim A.
Formato: research Journal Article
Publicado: Elsevier B.V. Nov2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2022
      vid: 44
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      pub: Elsevier B.V.
      place: New York, New York
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        159742830
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        10.1016/j.carrev.2022.06.261
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        159742830
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        atl: Intracoronary Lithotripsy Use for In-Stent Restenosis, Including Multilayer ISR.
      aug:
        au:
          Kassab, Kameel
          Kassier, Adnan
          Fischell, Tim A.
        affil: Division of Cardiology, Ascension Borgess Heart Institute, Kalamazoo, MI, USA
      sug:
        subj:
          Coronary Restenosis Etiology
          Coronary Restenosis
          Lithotripsy Adverse Effects
          Coronary Restenosis Therapy
          Risk Factors
          Stents Adverse Effects
          Constriction, Pathologic
          Retrospective Design
          Treatment Outcomes
          Short Portable Mental Status Questionnaire
      ab: Introduction: Intravascular lithotripsy (IVL) has been well characterized as a safe and effective method for plaque modification in the treatment of de-novo, calcific coronary artery disease. In-stent restenosis (ISR) remains a major challenge in coronary revascularization, especially "multilayer" ISR. The use of IVL in ISR remains off-label and has been described in case reports and small case series. We report the single-center experience using IVL for the treatment of ISR, including multilayer ISR.Materials and Methods: This was a retrospective single-center study. All intracoronary percutaneous interventions requiring lithotripsy use, between May 2021 and December 2021, were reviewed. We selected only the cases involving IVL use for the treatment of in-stent restenosis. Baseline characteristics of patients were obtained from chart review. Procedural details and outcomes were obtained from reports and from a detailed review of procedural images.Results: A total of 13 ISR lesions were treated with IVL, of which 5 were in cases of multilayer ISR. Procedural success was observed in 11 lesions. Three patients had recurrent angina during a mean follow-up of 133 days. None of the patients had hard outcomes of myocardial infarction or cardiac death during the follow-up period.Conclusion: IVL is feasible and safe for ISR treatment including multilayer ISR. IVL is associated with good immediate procedural success, and a low rate of short-term adverse outcomes.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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