Complications after intravascular lithotripsy are rare, real-world data confirm
Complications after intravascular lithotripsy are rare, real-world data confirm
Source: JSCAI
Published on July 23, 2025
Key Notes:
1. What is IVL?
Intravascular lithotripsy (IVL) is a technique that uses low-pressure shockwaves to break calcium deposits in coronary arteries. It helps improve stent placement in calcified lesions.
2. Study Purpose:
Previous trials showed IVL is safe, but excluded high-risk patients. This study examined real-world data from over 500 patients treated between 2019–2024 in Europe.
3. Key Findings:
• Average patient age: 73 years; 75% were men.
• Complication rate: 6% overall.
• Immediate complications: Only 1%.
• Common issues: coronary dissections, hemodynamic instability, and perforations.
4. Impact of Complications:
• Patients with complications had a much higher chance of major cardiovascular events (MACE) within one year (11% rate overall).
• 30 extra procedures were needed to manage complications.
5. Risk Factors:
• Higher balloon-to-artery ratio linked to more complications.
• Using other plaque-modification tools did not increase risk.
6. How IVL compares to other techniques:
• Similar success rate to rotational (RA) and orbital atherectomy (OA).
• Fewer complications, easier to use, and requires less training.
7. Conclusion:
IVL is a safe and effective option for real-world patients with calcified coronary artery disease, even in complex cases. However, more randomized trials are needed.
