Conversations in Interventional Cardiology: Incidence of Complications Following Coronary IVL, Clinical Outcomes and Predictors of Complications-Conversations in Interventional Cardiology: Incidence of Complications Following Coronary IVL, Clinical Outcomes and Predictors of Complications

Conversations in Interventional Cardiology: Incidence of Complications Following Coronary IVL, Clinical Outcomes and Predictors of Complications

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Video Summary

This J-SKY discussion reviewed a multicenter European registry of 509 patients undergoing coronary intravascular lithotripsy (IVL) for complex, heavily calcified lesions, including many acute coronary syndrome cases, bifurcations, ostial lesions, CTOs, and restenosis. Overall complications were uncommon (6%), and only about 1% were directly related to IVL itself. Procedural success was high, with residual stenosis under 30% in about 90% of lesions. Patients who had complications experienced higher 30-day and 1-year MACE, mainly driven by in-hospital events. The main predictor of complications was a higher balloon-to-artery ratio. Panelists emphasized that IVL is easy to use, effective, and generally safer than atherectomy approaches, while still noting important roles for rotational, orbital, and laser atherectomy in selected very tight or uncrossable lesions. Future research should refine IVL dosing, better define use in nodular calcium, and explore combinations with drug-coated balloons to reduce stent use.

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Keywords

coronary intravascular lithotripsy

calcified coronary lesions

procedural complications

atherectomy

calcium

laser

orbital

plaque

drug-coated balloons