(P055) ONE-YEAR OUTCOMES IN PATIENTS WHO UNDERWENT CORONARY INTRAVASCULAR SHOCKWAVE LITHOTRIPSY FOR HIGHLY-CALCIFIED CORONARY LESIONS

Thursday, October 27, 2022

1:40 PM – 1:50 PM EDT

Location: ePoster Screen 4

Presenter(s)

Sarah Gibbs, MD

Internal Medicine Resident
University of Manitoba
Winnipeg, Manitoba, Canada

First Author(s)

Sarah Gibbs, MD

Internal Medicine Resident
University of Manitoba
Winnipeg, Manitoba, Canada

Senior Author(s)

Evan J. Wiens, MD, MSc, FRCPC

Adult Cardiology Fellow
University of Manitoba
Winnipeg, Manitoba, Canada

Supervisor(s)

KM

Kunal Minhas, MD, FRCP(C)

Interventional Cardiologist
St.Boniface General Hospital
University of Manitoba
Winnipeg, Manitoba, Canada

Background: Intravascular lithotripsy (IVL) has been shown to have excellent angiographic and short-term clinical results in patients with heavily calcified lesions who require percutaneous coronary intervention in both randomized and observational studies. However, there is limited data regarding the long-term outcomes in real-world patients. We conducted a follow up of a high-risk IVL cohort at a tertiary care centre to help better define outcomes over a 1-year period post IVL.

METHODS AND RESULTS: We conducted a retrospective cohort study of 50 consecutive patients who underwent IVL between September 1, 2019 and January 31, 2020. One-year outcomes were available for 47/50 patients; 3 patients who did not survive their index hospitalisation (for reasons unrelated to IVL) were excluded. The primary outcome was need for target vessel revascularization (TVR) at 1 year from index procedure. Secondary outcomes included cardiovascular mortality, myocardial infarction (MI), and freedom from angina. The mean age of the cohort was 71.5 years and 38% of patients were female. Fifty-three percent of patients presented with non-ST elevation ACS as the indication for initial IVL. Twenty-six percent of patients underwent IVL for lesions of the left main coronary artery, and 26% underwent IVL for in-stent restenosis (ISR). Of a total of 47 patients (61 lesions), 4% of patients (3% of lesions) required TVR within 1 year; 96% of patients who underwent IVL remained free from repeat intervention on the same vessel. Two (4%) suffered mortality at one year from non-cardiovascular causes. Eighty-five percent of patients remained free from angina at 1 year. One patient suffered an MI within 1 year; the culprit vessel had not previously been treated with IVL.

Conclusion: IVL is associated with favorable results out to 1 year with very low rates of TVR. This suggests that IVL is an effective and durable modality for treatment of highly calcified coronary lesions in high-risk patients, including those requiring IVL for the indication of ACS or ISR.