The American journal of cardiology · 2026
Coronary Artery Compliance Modification after Noncompliant Balloon Angioplasty and Intravascular Lithotripsy.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Oliveri Federico, van Oort Martijn J H, Phagu Akshay, Bingen Brian O, Paradies Valeria, Claessen Bimmer, Dimitriu-Leen Aukelien C, Kefer Joelle, Girgis Hany, Vossenberg Tessel, Mandurino-Mirizzi Alessandro, Van der Kley Frank, Jukema J Wouter, Amri Ibtihal Al, Montero-Cabezas José M
Аннотация
BACKGROUND: Intravascular lithotripsy (IVL) has demonstrated efficacy in treating balloon-crossable calcified coronary lesions by inducing calcium fractures and improving coronary artery compliance (CACom). However, a direct comparison between IVL and non-compliant (NC) balloon angioplasty with respect to compliance modification has not yet been reported.
METHODS: From the BENELUX-IVL prospective registry (NCT06577038), patients with calcified coronary artery lesions treated with IVL under intravascular ultrasound (IVUS) guidance were selected. CACom was calculated as the systo-diastolic change in luminal area (ΔA), measured using IVUS, divided by the corresponding change in aortic pressure (ΔP). CACom was assessed at three time points: (1) before NC balloon inflation (baseline), (2) after NC balloon inflation but prior to IVL (post-NC), and (3) after IVL pulse delivery (post-IVL). The NC balloon effect was defined as the difference between post-NC and baseline CACom; the IVL effect was defined as the difference between post-IVL and post-NC CACom.
RESULTS: Twenty-four patients, for a total of 28 lesions, were pertinent for inclusion. CACom increased from 0.17 [0.12-0.23] mm2/mmHg at baseline to 0.32 [0.25-0.52] mm2/mmHg post-NC, and to 0.65 [0.44-0.84] mm2/mmHg post-IVL. The median NC effect was 0.14 [0.10-0.28] mm2/mmHg (p <0.01), and the IVL effect was 0.23 [0.13-0.37] mm2/mmHg (p <0.01). The IVL effect was significantly greater than the NC effect (p = 0.03).
CONCLUSIONS: sequential NC balloon angioplasty and IVL significantly improved coronary compliance, with IVL yielding a greater compliance gain, supporting its role in optimizing lesion preparation in calcified coronary arteries.
METHODS: From the BENELUX-IVL prospective registry (NCT06577038), patients with calcified coronary artery lesions treated with IVL under intravascular ultrasound (IVUS) guidance were selected. CACom was calculated as the systo-diastolic change in luminal area (ΔA), measured using IVUS, divided by the corresponding change in aortic pressure (ΔP). CACom was assessed at three time points: (1) before NC balloon inflation (baseline), (2) after NC balloon inflation but prior to IVL (post-NC), and (3) after IVL pulse delivery (post-IVL). The NC balloon effect was defined as the difference between post-NC and baseline CACom; the IVL effect was defined as the difference between post-IVL and post-NC CACom.
RESULTS: Twenty-four patients, for a total of 28 lesions, were pertinent for inclusion. CACom increased from 0.17 [0.12-0.23] mm2/mmHg at baseline to 0.32 [0.25-0.52] mm2/mmHg post-NC, and to 0.65 [0.44-0.84] mm2/mmHg post-IVL. The median NC effect was 0.14 [0.10-0.28] mm2/mmHg (p <0.01), and the IVL effect was 0.23 [0.13-0.37] mm2/mmHg (p <0.01). The IVL effect was significantly greater than the NC effect (p = 0.03).
CONCLUSIONS: sequential NC balloon angioplasty and IVL significantly improved coronary compliance, with IVL yielding a greater compliance gain, supporting its role in optimizing lesion preparation in calcified coronary arteries.