Intracoronary Lithotripsy Use for In-Stent Restenosis, Including Multilayer ISR

• Published in: Cardiovascular revascularization medicine Vol. 44; pp. 10 - 13
• Main Authors: Kassab, Kameel, Kassier, Adnan, Fischell, Tim A.
• Format: Journal Article
• Language: English
• Published: 01.11.2022
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2022.06.261

INTRODUCTIONIntravascular lithotripsy (IVL) has been well characterized as a safe and effective method for plaque modification in the treatment of de-novo, calcific coronary artery disease. In-stent restenosis (ISR) remains a major challenge in coronary revascularization, especially "multilayer" ISR. The use of IVL in ISR remains off-label and has been described in case reports and small case series. We report the single-center experience using IVL for the treatment of ISR, including multilayer ISR. MATERIALS AND METHODSThis was a retrospective single-center study. All intracoronary percutaneous interventions requiring lithotripsy use, between May 2021 and December 2021, were reviewed. We selected only the cases involving IVL use for the treatment of in-stent restenosis. Baseline characteristics of patients were obtained from chart review. Procedural details and outcomes were obtained from reports and from a detailed review of procedural images. RESULTSA total of 13 ISR lesions were treated with IVL, of which 5 were in cases of multilayer ISR. Procedural success was observed in 11 lesions. Three patients had recurrent angina during a mean follow-up of 133 days. None of the patients had hard outcomes of myocardial infarction or cardiac death during the follow-up period. CONCLUSIONIVL is feasible and safe for ISR treatment including multilayer ISR. IVL is associated with good immediate procedural success, and a low rate of short-term adverse outcomes.