Histology, OCT, and Micro-CT Evaluation of Coronary Calcification Treated With Intravascular Lithotripsy: Atherosclerotic Cadaver Study

A recent study from CVPath Institute was published in the September 11th issue of JACC: Cardiovascular Interventions. The new data, reported by Kenji Kawai in collaboration with his colleagues, confirmed that intravascular lithotripsy (IVL) is the leading effective treatment for calcified coronary lesions compared to plain old balloon angioplasty (POBA). Histological analysis and intravascular imaging using OCT and microCT scans highlighted this important finding from the cadaver study, in which eight coronary lesions (IVL-treated) and another seven lesions (POBA-treated) were assessed.

When a patient undergoes a percutaneous coronary or peripheral arterial intervention (PCI), a procedure to help mitigate the narrowing of diseased coronary arteries, it is common for calcifications which are part of the disease process to interfere with the procedure. IVL can disrupt vascular calcification by fracturing the area of calcification without harm to the surrounding tissue. Kawai stated, “IVL demonstrated a histologically superior fracturing effect on coronary calcification lesions compared with POBA.”[1]

Assessment data from the study also revealed that micro-computed tomography (microCT) had greater accuracy at detecting calcium fracture depth compared to optical coherence tomography (OCT).

In an article from CRTonline summarizing the study’s findings, the editorial staff commended Kawai and his colleagues for “advancing understanding of calcium modification by IVL and how intravascular imaging can identify potential predictors of therapeutic response”.[2]

Written by Gina Miller

Image Credit: Pijitra – stock.adobe.com