Associazione Nazionale Medici Cardiologi Ospedalieri



Intravascular lithotripsy for the treatment of severely calcified coronary stenosis in Acute Myocardial Infarction

Pavani Marco Torino (Torino) – Aou San Luigi Gonzaga Orbassano – Ospedale Degli Infermi Di Rivoli | Franzè Alfonso Torino (Torino) – Aou San Luigi Gonzaga Orbassano – Ospedale Di Rivoli | Cinconze Sebastian Cuneo (Cuneo) – Ospedale Santa Croce E Carle | Barbero Umberto Savigliano (Cuneo) – Ospedale Ss.Annunziata | Meliga Emanuele Asti (Asti ) – Ospedale Cardinal Massaia | Rognoni Andrea Biella (Biella) – Ospedale Degli Infermi | Nicolino Anna Maria Pietra Ligure (Savona) – Ospedale Santa Corona | Biasco Luigi Ciriè (Torino) – Ospedale Di Ciriè | Conrotto Federico Torino (Torino) – Città Della Salute E Della Scienza | Ugo Fabrizio Vercelli (Vercelli) – Ospedale Sant’Andrea | Scacciatella Paolo Aosta (Aosta) – Ospedale Parini | Tomassini Francesco Torino (Torino) – Ospedale Di Rivoli – Aou San Luigi Gonzaga Orbassano | Leoncini Massimo Sanremo (Sanremo) – Ospedale Borea | Menozzi Alberto La Spezia (La Spezia) – Ospedale La Spezia | Patti Giuseppe Novara (Novara) – Aou Maggiore Della Carità | Rolandi Andrea Genova (Genova ) – Ospedale Galliera | Porto Italo Genova (Genova) – Aou San Martino Di Genova | Musumeci Giuseppe Torino (Torino) – Ospedale Mauriziano Umberto I | Cerrato Enrico Torino (Torino) – Ospedale Di Rivoli – Aou San Luigi Gonzaga Orbassano | Varbella Ferdinando Torino (Torino) – Ospedale Di Rivoli – Aou San Luigi Gonzaga Orbassano


Little is known about intraprocedural and mid-term results of intravascular lithotripsy (IVL) use in patients with acute MI.


In Our retrospective analysis, data from 21 Centers in Italy and Spain between January 2020 and November 2021 were collected. Patients were allocated to the AMI-group when IVL was performed during an acute MI. Primary safety endpoint was defined as freedom from major adverse cardiac events (MACE: cardiac death, myocardial infarction (MI), target vessel revascularization (TLR) or stent thrombosis (ST)) within 30 days of the index procedure, and primary effectiveness endpoint was procedural success (defined as stent delivery with a residual stenosis <20% and without intraprocedural MACE). The mid-term endpoint was 6-months MACE.


A total of 468 patients were retrospectively enrolled. The primary safety endpoint was achieved in 98.8% of patients in the AMI-group and in 98.5% in the non-AMI group (p=NS). We showed a lower incidence of the primary effectiveness endpoint in the AMI-group (89.8%) vs Non AMI-group (94.8%) (p=0.048). The secondary endpoint of 6-months MACE was similar between groups (6.7% vs 4.9% respectively for AMI group and Non AMI-group), but death for cardiac causes occurred more frequently in the AMI-group (4.3% vs 0%, p=0.01).


Intravascular lithotripsy demonstrated to be a safe tool for the treatment of calcified coronary lesions during Acute Myocardial infarction, even if we showed some concern for lower procedural success.