Ney Carter Borges: New Trial Highlights IVL as Effective Strategy for Calcified Coronary Lesions
Ney Carter Borges, Member Cardiologist of Global Physician Association at Cleveland Clinic Florida, shared a post on LinkedIn about a recent article by Benjamin Honton et al, published in EuroIntervention, adding:
“ICARE OFDI was a multicenter, prospective, randomized non-inferiority trial comparing intravascular lithotripsy (IVL) with rotational atherectomy (RA) for preparation of moderate-to-severe calcified coronary lesions before PCI.
All procedures were guided by optical frequency domain imaging.
In 169 patients:
- RA n=86
- IVL n=83
IVL was non-inferior to RA for the primary imaging endpoint, minimal stent area: 6.0 plus/minus 2.3 square millimeter versus 5.9 plus/minus 2.2 square millimeter, respectively.
Adequate stent expansion was identical in both groups, 65.1 percent versus 65.1 percent, while major strut malapposition was significantly more frequent after RA: 80.2 percent versus 57.8 percent; p=0.002.
Clinically, both strategies had similar procedural safety and very low 12-month target lesion failure: RA 1.2 percent versus IVL 2.4 percent; p=0.61.
Clinical interpretation: IVL appears to be a valid alternative to RA for stable calcified coronary lesions, offering comparable stent expansion and outcomes, with less major malapposition.
However, the trial was relatively small and powered for an imaging endpoint, not hard clinical outcomes.
Larger trials are still needed before declaring IVL superior.”
Title: Intravascular lithotripsy in comparison to rotational atherectomy for calcified lesions: the ICARE OFDI randomised trial
Authors: Benjamin Honton, Pascal Motreff, Jean-Sébastien Mallet, Thomas Hovasse, Matthieu Godin, Guilhem Malclès, Jerome Brunet, Nicolas Meneveau, Pierre Deharo, Benoit Lattuca, Erwan Bressollette, Michael Angioi, Hakim Benamer, Edouard Gerbaud, Bruno Pereira, Vincenzo Cesario, Antoine Poinas, Clémence Laperche, Antoine Sauguet, Géraud Souteyrand, Nicolas Amabile, Nicolas Combaret

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