Intra-vascular lithotripsy (IVL) effectively treats calcified stent failure, but stent age may affect results. Cumulative data supports IVL use across cases. The study published in the Journal of Cardiology checked if early, mid-term, or late failure timing changes procedural success and one-year outcomes.
Methods Analyze COIL Registry Subgroup
Researchers used pre-specified COIL registry data on 88 patients treated with IVL for stent failure. They grouped by stent age: early (≤12 months, n=40), mid-term (12-36 months, n=17), late (>36 months, n=31). They tracked procedural results and one-year primary endpoint of cardiovascular death, spontaneous MI, or target vessel revascularization.
Results Favor Early Stent Failure Cases
Procedural success was strongest in early SF compared to mid-term or late groups. One-year primary endpoint rates rose with stent age: 8% early, 12% mid-term, 29% late (p=0.042). Target vessel revascularization drove differences (3% vs. 12% vs. 29%, p=0.005).
Conclusions Call for Timing-Based Strategies
IVL outcomes worsen with older stents in stent failure treatment. Early cases show best procedural and clinical results. Studies should explore why late failures resist IVL and guide patient selection.