Litotricia intracoronaria en pacientes de la vida realPrimera experiencia en lesiones complejas y gravemente calcificadas

  1. Victoria Vilalta 1
  2. Oriol Rodríguez-Leor 1
  3. Alfredo Redondo Diéguez 2
  4. B. Cid Álvarez 2
  5. Eduard Fernández Nofrerias 1
  6. Xavier Carrillo 1
  7. R. Trillo Nouche 2
  8. Omar Abdul-Jawad Altisent 1
  9. Sanmartín Pena, Juan Carlos
  10. Josepa Mauri Ferré 1
  11. Jean Christophe Barahona Alvarado 3
  12. Diego López Otero 2
  13. José Ramón González Juanatey 2
  14. Antoni Bayes Genis 1
  1. 1 Institut del Cor, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Institut per la Recerca Germans Trias i Pujol, Badalona, Barcelona, España; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España
  2. 2 Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España; Servicio de Cardiología, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, A Coruña, España
  3. 3 Institut del Cor, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Institut per la Recerca Germans Trias i Pujol, Badalona, Barcelona, España
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Journal:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Year of publication: 2020

Volume: 2

Issue: 2

Pages: 76-81

Type: Article

DOI: 10.24875/RECIC.M19000092 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

More publications in: REC: Interventional Cardiology

Abstract

Introduction and objectives: Complex calcified lesions can affect stent expansion and lead to stent failure and adverse outcomes. Intracoronary lithotripsy (ICL) has emerged as a new tool that enables calcium modification. The Disrupt CAD II clinical trial has recently evaluated the safety and feasibility of ICL in patients with stable coronary disease and calcified coronary lesions. Although its use has increased rapidly, the experience already reported with this new device is limited. We report the results in real-life complex patients with heavy coronary calcification. Methods: From October 2018 to March 2019, 25 patients (37 calcified lesions) were treated in 2 Spanish centers, which accounted for 2.7% of the patients treated with percutaneous coronary intervention. Results: The device and clinical success rates were 84% and 95%, respectively. No procedure-related complications were seen. The crossing rate of the ICL balloon was 100% and balloon rupture during inflation occurred in 8%. The ICL was performed in a subset of highly complex lesions like left main coronary artery lesions and chronic total coronary occlusions. Compared to the Disrupt CAD II trial, our patients were younger but their clinical scenario was worse with a higher prevalence of diabetes (68%), renal failure (22%), and up to 76% suffered from acute coronary syndrome. The ICL failed to reach proper expansion in 3 out of 4 cases of stent underexpansion. The procedure was performed safely, and clinical and device success were high with no in-hospital mortality. One patient died of non-cardiac causes at the 30-day follow-up. Conclusions: The ICL-assisted percutaneous coronary intervention was performed safely and effectively in a real-life cohort of patients with calcified and highly complex lesions.

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