A027 Coronary Intravascular Lithotripsy; Early Experiences at a Single Centre

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. All patients treated with Shockwave Intravascular Lithotripsy (S-IVL) between October 2018 and February 2020 at Christchurch Public Hospital were included. 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. 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.