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Abstract：
BACKGROUND: The purpose of this study was to evaluate the effectiveness of intravascular lithotripsy (IVL) in the treatment of severe coronary artery calcification (CAC) lesions.
METHODS: In this study, we selected patients diagnosed with severe CAC lesions confirmed by coronary angiography (CAG) who were hospitalized in Yulin First People\'s Hospital between December 2021 and December 2022 and required percutaneous coronary intervention (PCI). Using a random number table, we divided all patients into the IVL group and the PCI group in the order of interventional therapy. We compared both groups in terms of the surgical success rate, intraoperative manipulation characteristics, procedural complication, and cumulative incidence of major adverse cardiovascular events (MACE).
RESULTS: (1) There were no differences in the surgical success rate, incidence of MACE, and occurrence of procedural complication between the two groups; (2) Compared with the conventional PCI group, patients in the IVL group used fewer predilatation balloons, and the difference was statistically significant (all P < 0.05); (3) Compared with the conventional PCI group, patients in the IVL group had lesser surgery time and lesser radiation time, with lesser proportion of patients who were assisted with stent implantation using coronary artery rotational atherectomy, and this difference was statistically significant (P < 0.05); (4) The mean stent diameter and length in the IVL group was greater than those in the conventional PCI group but the difference was not statistically significant (P > 0.05).
CONCLUSIONS: In this study, we found that IVL was a highly safe and effective procedure in the treatment of severe CAC lesions that did not increase the surgery and radiation time, and it could also reduce the use of predilatation balloons, thus improving the management of CAC lesions. Thus, IVL can be a novel choice in treating severe CAC lesions.
METHODS: In this study, we selected patients diagnosed with severe CAC lesions confirmed by coronary angiography (CAG) who were hospitalized in Yulin First People\'s Hospital between December 2021 and December 2022 and required percutaneous coronary intervention (PCI). Using a random number table, we divided all patients into the IVL group and the PCI group in the order of interventional therapy. We compared both groups in terms of the surgical success rate, intraoperative manipulation characteristics, procedural complication, and cumulative incidence of major adverse cardiovascular events (MACE).
RESULTS: (1) There were no differences in the surgical success rate, incidence of MACE, and occurrence of procedural complication between the two groups; (2) Compared with the conventional PCI group, patients in the IVL group used fewer predilatation balloons, and the difference was statistically significant (all P < 0.05); (3) Compared with the conventional PCI group, patients in the IVL group had lesser surgery time and lesser radiation time, with lesser proportion of patients who were assisted with stent implantation using coronary artery rotational atherectomy, and this difference was statistically significant (P < 0.05); (4) The mean stent diameter and length in the IVL group was greater than those in the conventional PCI group but the difference was not statistically significant (P > 0.05).
CONCLUSIONS: In this study, we found that IVL was a highly safe and effective procedure in the treatment of severe CAC lesions that did not increase the surgery and radiation time, and it could also reduce the use of predilatation balloons, thus improving the management of CAC lesions. Thus, IVL can be a novel choice in treating severe CAC lesions.
摘要：
背景：本研究的目的是评估血管内碎石术（IVL）治疗严重冠状动脉钙化（CAC）病变的有效性。
方法：在本研究中，我们选取2021年12月至2022年12月在榆林市第一人民医院住院并需要经皮冠状动脉介入治疗(PCI)的经冠状动脉造影(CAG)证实为严重CAC病变的患者.使用随机数表，我们将所有患者按介入治疗的先后顺序分为IVL组和PCI组。我们比较了两组的手术成功率，术中操作特点，手术并发症,和主要不良心血管事件（MACE）的累积发生率。
结果：(1)手术成功率无差异，MACE的发生率,术中并发症的发生情况;(2)与常规PCI组比较,IVL组患者使用较少的预扩张球囊，差异有统计学意义(均P<0.05);(3)与常规PCI组相比,IVL组患者的手术时间较少，放疗时间较少，使用冠状动脉旋转粥样斑块切除术辅助支架植入的患者比例较低，差异有统计学意义(P<0.05);(4)IVL组的平均支架直径和长度大于常规PCI组,但差异无统计学意义(P>0.05)。
结论：在这项研究中，我们发现IVL是治疗严重CAC病变的高度安全和有效的方法，不会增加手术和放疗时间，它还可以减少膨胀气球的使用，从而改善CAC病变的管理。因此，IVL可能是治疗严重CAC病变的新选择。
方法：在本研究中，我们选取2021年12月至2022年12月在榆林市第一人民医院住院并需要经皮冠状动脉介入治疗(PCI)的经冠状动脉造影(CAG)证实为严重CAC病变的患者.使用随机数表，我们将所有患者按介入治疗的先后顺序分为IVL组和PCI组。我们比较了两组的手术成功率，术中操作特点，手术并发症,和主要不良心血管事件（MACE）的累积发生率。
结果：(1)手术成功率无差异，MACE的发生率,术中并发症的发生情况;(2)与常规PCI组比较,IVL组患者使用较少的预扩张球囊，差异有统计学意义(均P<0.05);(3)与常规PCI组相比,IVL组患者的手术时间较少，放疗时间较少，使用冠状动脉旋转粥样斑块切除术辅助支架植入的患者比例较低，差异有统计学意义(P<0.05);(4)IVL组的平均支架直径和长度大于常规PCI组,但差异无统计学意义(P>0.05)。
结论：在这项研究中，我们发现IVL是治疗严重CAC病变的高度安全和有效的方法，不会增加手术和放疗时间，它还可以减少膨胀气球的使用，从而改善CAC病变的管理。因此，IVL可能是治疗严重CAC病变的新选择。
