Evaluation of the Intravascular Ultrasound Calcium Scoring System in Guiding Intravascular Lithotripsy During Percutaneous Coronary Intervention.

Authors

Shun Kitajima, Masaomi Gohbara, Kyoko Hattori, Yohei Hanajima, Katsuhiko Tsutsumi, Hidekuni Kirigaya, Jin Kirigaya, Shinnosuke Kikuchi, Hidefumi Nakahashi, Yuichiro Kimura, Kensuke Matsushita, Kozo Okada, Noriaki Iwahashi, Masami Kosuge, Teruyasu Sugano, Toshiaki Ebina, Kiyoshi Hibi

Published in

Circulation journal : official journal of the Japanese Circulation Society. Sep 27, 2025. Epub Sep 27, 2025.

Abstract

In Japan, intravascular lithotripsy (IVL) is indicated during percutaneous coronary intervention (PCI) for calcified lesions when the calcium score assessed by intravascular ultrasound (IVUS) or optical coherence tomography (OCT) is ≥3. This study evaluated the effectiveness of IVL in achieving optimal stent expansion in lesions with an OCT calcium score ≥3, regardless of the IVUS calcium score.
We retrospectively compared 26 consecutive PCIs in 23 patients who underwent IVL with pre-PCI OCT or optical frequency domain imaging and simultaneous pre- and post-PCI IVUS with 102 patients who underwent PCI without atherectomy but similar imaging protocols. Of all 128 PCIs, 84 with an OCT calcium score ≥3 and a simultaneous IVUS calcium score ≤2 were analyzed. Stent expansion was measured by IVUS. Among the 84 PCIs included in the analysis, 17 were performed using IVL and 67 were performed without atherectomy or IVL (non-IVL group). Stent expansion at the site of maximum superficial calcium was greater in the IVL than non-IVL group (90.9% vs. 84.6%, respectively; P=0.028). The non-IVL group was independently associated with reduced stent expansion at the site of maximum superficial calcium, even after adjusting for IVUS calcium score components (B=-0.817; P<0.001).
Even in calcified lesions with an IVUS calcium score ≤2, IVL was independently associated with favorable stent expansion when the OCT calcium score was ≥3.

PMID:
41016754
Bibliographic data and abstract were imported from PubMed on 29 Sep 2025.

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