Analysis of the safety of intravascular lithotripsy and rotational atherectomy in the management of coronary artery calcification
10.3969/j.issn.1004-8812.2025.11.005
- VernacularTitle:经皮冠状动脉腔内冲击波球囊导管成形术和冠状动脉斑块旋磨术对冠状动脉钙化处理的安全性分析
- Author:
Zhang-ying WU
1
;
Li ZHU
;
Su LI
;
Jia HUANG
;
Yu-xiang DAI
Author Information
1. 复旦大学附属中山医院心血管内科,上海 200032;青岛市黄岛区人民医院心血管内科,山东青岛 266400
- Publication Type:Journal Article
- Keywords:
Coronary calcification;
Intravascular lithotripsy;
Coronary rotational atherectomy;
Coronary artery stenosis
- From:
Chinese Journal of Interventional Cardiology
2025;33(11):634-639
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the safety of intravascular lithotripsy(IVL)and coronary rotational atherectomy(RA)in the management of coronary artery calcification(CAC).Methods In this retrospective,matched-pair cohort study,210 patients with severe CAC treated at Zhongshan Hospital,Fudan University between December 2021 and April 2025 were enrolled.The cohort was equally divided into two interventional groups:IVL group(n=105)and RA group(n=105),based on the revascularization strategy employed.Procedure parameters,postoperative biochemical markers of myocardial injury,and incidence of in-hospital major adverse cardiovascular events(MACE)were compared between the two groups.Results Before propensity score matching(PSM),statistically significant differences were observed in terms of the proportions of the left anterior descending artery(77.1％vs.63.8％,P=0.034),the right coronary artery(14.3％vs.30.5％,P=0.005),and the percentage of target vessel stenosis[85％(80％,90％)vs.80％(80％,90％),P=0.014]between the IVL and RA groups.After PSM,these differences became insignificant(all P＞0.05).There is no statistically significant differences in stent implantation rate,drug-coated balloon usage rate,stent diameter,or total stent length between the IVL and RA groups(all P＞0.05).Compared to the RA group,although the IVL group had a higher utilization of tirofiban after the procedure,and a lower rate of intravenous nitrate during the procedure,these differences were not statistically significant(all P＞0.05).cTnT levels increased significantly after the procedure in both the IVL and RA groups(all P＜0.001).Before PSM,the preoperative cTnT levels were comparable between the IVL and RA groups(P=0.525),while a statistically significant difference emerged postoperatively(P=0.038).The incidence of in-hospital myocardial infarction showed no significant intergroup difference(8.6％vs.16.2％,P=0.094),and no events of death or target vessel revascularization occurred in either group.After PSM,despite no significant difference in preoperative cTnT levels between the IVL and RA groups(P=0.235),a significant difference was observed postoperatively(P=0.014).Furthermore,while no deaths or target vessel revascularization occurred in either group,the IVL group demonstrated a significantly lower incidence of in-hospital myocardial infarction compared to the RA group(9.9％vs.23.9％,P=0.025).Conclusions The use of intravascular lithotripsy for the pretreatment in patients with severe CAC is safe and promising.
