Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Lesions: 1-Year Results From the Disrupt CAD III Study

BackgroundCoronary calcification impairs stent delivery and optimal expansion, a significant predictor of subsequent thrombosis restenosis. Current calcium ablative technologies may be limited by guidewire bias periprocedural complications. Intravascular lithotripsy (IVL) delivers acoustic pressure waves to modify calcium, enhance vessel compliance, optimize deployment. The Disrupt CAD III study demonstrated high (92.4%) procedural success low (7.8%) 30-day major adverse cardiac event (MACE) rates following IVL, but longer term follow-up is required determine the durability clinical benefit late impact optimized implantation associated with IVL. This analysis evaluates 1-year outcomes from study.MethodsDisrupt (NCT03595176) was prospective, single-arm approval designed assess safety effectiveness IVL as an adjunct coronary stenting in de novo, severely calcified lesions (n = 384). MACE defined composite death, myocardial infarction (MI), or ischemia-driven target revascularization; lesion failure MI, revascularization (ID-TLR).ResultsAt 1 year, occurred 13.8% patients (cardiac death: 1.1%, MI: 10.5%, revascularization: 6.0%) 11.9% (ID-TLR: 4.3%), both driven non-Q-wave MI (9.2%). Stent (definite probable) 1.1% (including [0.3%] beyond 30 ​days).ConclusionsDisrupt represents largest long-term (1-year) date. treatment prior MACE, ID-TLR, thrombosis.