Associazione Nazionale Medici Cardiologi Ospedalieri

CONGRESS ABSTRACT

CONGRESS ABSTRACT

Intravascular lithotripsy for the treatment of severely calcified Left Main coronary stenosis.

Pavani Marco Torino (Torino) – Aou San Luigi Gonzaga Orbassano – Ospedale Degli Infermi Rivoli | Giacobbe Federico Torino (Torino) – Città Della Salute E Della Scienza Di Torino | Zanda Greca Torino (Torino) – Ospedale Di Rivoli – Aou San Luigi Gonzaga Orbassano | Sagazio Emanuele Asti (Asti) – Ospedale Cardinal Massaia | Vadalà Paolo Alba (Cuneo) – Ospedale Di Verduno | Galiffa Vincenzo Novara (Novara) – Aou Maggiore Della Carità Di Novara | Taglialatela Vittorio Chivasso (Torino) – Ospedale Di Chivasso | De Filippo Ovidio Torino (Torino) – Città Della Salute E Della Scienza Di Torino | Annibali Gianmarco Torino (Torino) – Ospedale Umberto I Mauriziano | Abdirashid Mohamed Vercelli (Vercelli) – Ospedale Sant’Andrea | Bernardi Alessando Aosta (Aosta) – Ospedale Parini | Benenati Stefano Genova (Genova) – Ospedale San Martino Di Genova | Arena Marco La Spezia (La Spezia) – Ospedale Civile Sant’Andrea | Ferrari Fabio Sanremo (Imperia) – Ospedale Borea | Cordone Stefano Savona (Savona) – Ospedale Di Savona | Piedimonte Giulio Torino (Torino) – Ospedale Di Rivoli – Aou San Luigi Gonzaga Di Orbassano | Rolfo Cristina Torino (Torino) – Ospedale Di Rivoli | Cerrato Enrico Torino (Torino) – Ospedale Di Rivoli – Aou San Luigi Gonzaga Orbassano | Varbella Ferdinando Torino (Torino) – Ospedale Di Rivoli – Aou San Luigi Gonzaga Orbassano

BACKGROUND: Even if pilot studies have been conducted to validate Intravascular Lithotripsy, most challenging cases were excluded, including unprotected Left Main (LM) coronary stenosis. 

METHODS: We retrospectively enrolled patients treated with IVL in a real-world multicenter registry from 21 centers among Italy and Spain from January 2020 to November 2021. The primary safety endpoint was freedom from major adverse cardiovascular events (cardiac death, target vessel revascularization, stent thrombosis) at 30 days. The primary effectiveness endpoint was procedural success (defined as stent delivery with a residual stenosis <20% and without intra-procedural MACE). Secondary endpoint were 6-months and 12-months  MACE rates.

RESULTS: From a total amount of 470 patients enrolled in our registry, 41 underwent IVL to LM stenosis. Most of them were males (78.0%). The clinical presentation was acute coronary syndrome (ACS) in 41.4% of cases. Mechanical circulatory support was necessary in 4 cases (9.7%). IVL before stent implantation was planned in 90% of cases. The primary safety endpoint occurred in 97.6%. of patients. The primary effectiveness endpoint was achieved in 97.6% of cases. Interestingly, at 6 months and 12 months, no MACE was recorded. 

CONCLUSIONS: Intravascular lithotripsy for the treatment of severely calcified Left Main stenosis seems to be a safe and effective option with very high procedural success rate and low MACE rate at follow-up.