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?:abstract
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Background: Intravascular lithotripsy is a recent treatment option for heavily calcified coronary lesions which has been validated in patients with stable angina symptoms This study presents early real-world experiences in a single centre using Shockwave-Intravascular Lithotripsy Methods: All patients treated with Shockwave Intravascular Lithotripsy (S-IVL) between October 2018 and February 2020 at Christchurch Public Hospital were included Results: A total of 47 patients underwent S-IVL during this period (Mean Age 71±7 9 years, 80% male) Indications were Acute Coronary Syndrome in 30 patients (63%, 21 NSTEMI, 6 STEMI, 2 UA, 1 OOHCA), stable angina in 15 patients (32%), and pre-TAVI PCI in 2 patients (5%) The target vessels were LMS (3 patients, 6%), LAD (30 patients, 64%), RCA (10 patients, 21%), LCx (7 patients, 15%), and a SVG-OM graft (1 patient) The majority (41 patients, 87%) underwent pre-dilation prior to S-IVL, 4 patients had initial treatment with S-IVL, and there was 1 bailout post stent insertion for suboptimal stent expansion and 1 patient post rotablation OCT/IVUS guidance was used in 8 cases (17%) Procedural complications occurred in 4 cases (2 coronary artery dissection following balloon rupture treated with stenting, 1 stroke, and 1 acute pulmonary oedema) There was balloon rupture in 9 cases (19%) All patients achieved angiographic success, with symptomatic improvement in 92% of cases Conclusion: S-IVL is gaining popularity for treating severely calcified coronary artery disease Our experience shows good outcomes in both acute and elective settings, without significant long-term complications
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