778 IN-STENT USE OF INTRAVASCULAR LITHOTRIPSY IN THE TREATMENT OF STENT UNDEREXPANSION: A SYSTEMATIC REVIEW AND METAREGRESSION

Abstract Introduction Calcified coronary plaque (CCP) represents a challenging scenario for interventional cardiologist. Stent Underexpansion (SU), often associated with CCP, can predispose to stent thrombosis and in-stent restenosis. To date, SU heavily CCP be addressed by means of scoring/cutting balloons, very-high/high pressure non-compliant off-label rotational/orbital atherectomy intravascular lithotripsy (IVL). Objective In this meta-analysis we investigate the success rate IVL treatment due CCP. Methods Studies case-based experiences reporting on use strategy were included. The primary outcome was success, defined as adequate expansion underexpanded stent. Metanalysis performed main focuses calculate proportions procedural rates corresponding 95% confidence intervals (CI). Random effects models weighted inverse variance used because clinical heterogeneity. Results Our study included 13 studies 354 patients. Mean age 71.3 years (95% CI: 64.9-73.1) 77% 71.2-82.4%) male. mean follow-up time 2.6 months 1–15.3). Strategy seen in 88.7% 82.3–95.1) Minimal Area (MSA) reported 6 studies, pre-IVL value 3.4 mm2 3–3.8) post-IVL 6.9 6.5–7.4). diameter stenosis (%) 7 69.4% 60.7–78.2) 14.6% 11.1–18). intraprocedural complications 1.6% 0.3-2.9). Conclusions “stent-through” modification technique is safe tool treat high very low incidence complications.