Safety and Efficacy of Intravascular Lithotripsy in Calcified Left Main Coronary Artery Disease: A Systematic Review and Meta-Analysis
Shanmukh Sai Pavan Lingamsetty
Internal Medicine, Mamata Medical College, Khammam, India
Search for more papers by this authorCorresponding Author
Harshith Thyagaturu
Department of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA
Correspondence: Harshith Thyagaturu ([email protected])
Search for more papers by this authorSahib Singh
Internal Medicine, Sinai Hospital, Baltimore, Maryland, USA
Search for more papers by this authorAvinashsingh Eswarsingh
Department of cardiology, East Carolina University, Greenville, North Carolina, USA
Search for more papers by this authorShwetha Gopal
Department of Cardiology, Bassett Medical Center, New York, USA
Search for more papers by this authorDipesh Ludhwani
University of Maryland Shore Regional Health, Easton, Maryland, USA
Search for more papers by this authorAdemola Ajibade
Department of Medicine, West Virginia University, Morgantown, West Virginia, USA
Search for more papers by this authorVijaykumar Sekar
Department of Endocrinology, Lehigh Valley Health Network, Pennsylvania, USA
Search for more papers by this authorVikrant Jagadeesan
Department of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA
Search for more papers by this authorShanmukh Sai Pavan Lingamsetty
Internal Medicine, Mamata Medical College, Khammam, India
Search for more papers by this authorCorresponding Author
Harshith Thyagaturu
Department of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA
Correspondence: Harshith Thyagaturu ([email protected])
Search for more papers by this authorSahib Singh
Internal Medicine, Sinai Hospital, Baltimore, Maryland, USA
Search for more papers by this authorAvinashsingh Eswarsingh
Department of cardiology, East Carolina University, Greenville, North Carolina, USA
Search for more papers by this authorShwetha Gopal
Department of Cardiology, Bassett Medical Center, New York, USA
Search for more papers by this authorDipesh Ludhwani
University of Maryland Shore Regional Health, Easton, Maryland, USA
Search for more papers by this authorAdemola Ajibade
Department of Medicine, West Virginia University, Morgantown, West Virginia, USA
Search for more papers by this authorVijaykumar Sekar
Department of Endocrinology, Lehigh Valley Health Network, Pennsylvania, USA
Search for more papers by this authorVikrant Jagadeesan
Department of Cardiology, West Virginia University Heart and Vascular Institute, Morgantown, West Virginia, USA
Search for more papers by this authorABSTRACT
Background
Intravascular lithotripsy (IVL) has emerged as a novel therapeutic modality for the management of calcified coronary lesions. The effectiveness and safety of IVL specifically in the context of left main disease remains uncertain and limited. We performed a meta-analysis to consolidate existing data.
Methods
Online databases Medline, Embase, Cochrane were searched for studies using IVL during percutaneous coronary intervention (PCI) of calcified left main disease. The outcomes of interest were procedural success, procedural complications and cardiovascular (CV) events. Pooled proportions with 95% confidence intervals (CI) were calculated using a random-effects model.
Results
A total of 10 studies with 435 patients (mean age 73.1 years, 73.1% males) were included. The pooled outcomes were procedural success 98.8% (95% CI 95.58−100), perforation 0.02% (95% CI 0.00−0.87), major dissection 0.87% (95% CI 0.00−3.97), slow-flow/no-reflow 0.27% (95% CI 0.00−1.47) and abrupt vessel closure 0.01% (95% CI 0.00−1.01). In-hospital CV events were major adverse CV events (MACE) 2.14% (95% CI 0.64−4.21), death 0.96% (95% CI 0.00−2.98), CV death 0.46% (95% CI 0.00−2.17), myocardial infarction (MI) 0.94% (95% CI 0.04−2.56), stent thrombosis 0.99% (95% CI 0.00−6.14) and target vessel revascularization 0% (95% CI 0.00−0.32). Thirty-day outcomes were MACE 4.79% (95% CI 1.51−9.35), mortality 3.09% (95% CI 0.00−9.69) and MI 2.25% (95% CI 0.45−4.95).
Conclusions
Use of IVL during PCI of calcified left main disease is associated with a favorable procedural rates of success, with low risk of procedural complications and ischemic events.
Conflicts of Interest
The authors declare no conflicts of interest.
Open Research
Data Availability Statement
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Supporting Information
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