ArticleCirculation. Cardiovascular interventions2023
Impact of Calcium Eccentricity on the Safety and Effectiveness of Coronary Intravascular Lithotripsy: Pooled Analysis From the Disrupt CAD Studies.
Article in Circulation. Cardiovascular interventions, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06736665 (Comparative Efficacy of Orbital Atherectomy and Intravascular Lithotripsy in the Treatment of Calcified Coronary Nodules. The ORBIT-SHOCK Pilot Study.), which is not on this map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparative Efficacy of Orbital Atherectomy and Intravascular Lithotripsy in the Treatment of Calcified Coronary Nodules. The ORBIT-SHOCK Pilot Study.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Network meta-analysis of treatment strategies for calcified coronary lesions.Cardiovascular intervention and therapeutics · 2026Pooled it
- Review
- Calcified Plaque Detachment: Alternative Calcified Plaque Modification After Coronary Intravascular Lithotripsy.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Intravascular ultrasound evaluation of novel non-compliant versus conventional semi-compliant cutting balloon for calcified coronary lesions.Cardiovascular intervention and therapeutics · 2026Observational
- Endovascular revascularisation in chronic occlusive mesenteric ischaemia: safety and efficacy of intravascular lithotripsy.European radiology · 2026Article
- Association between intimal thickness of superficial calcified sheet and calcium fracture after intravascular lithotripsy.Heart and vessels · 2026Article
- Iatrogenic coronary artery dissection: detection, management, and prevention.Frontiers in cardiovascular medicine · 2026Review
- Drug-Coated Balloons for Coronary Artery Disease: From Theory to Practice.Current treatment options in cardiovascular medicine · 2025Article
- Use of Calcium Modification in Percutaneous Coronary Intervention: A Comprehensive Review.Journal of clinical medicine · 2025Review
- The potential role of major dissection observed on optical frequency-domain imaging in optimal lumen expansion after coronary intravascular lithotripsy: a comparative analysis with calcium fractures.Cardiovascular intervention and therapeutics · 2025Article
- Fine-tuning the arc of orbital atherectomy: navigating eccentric calcium in tortuous vessels.AsiaIntervention · 2025Article
- Challenging the No-Stent Zone: Intravascular Lithotripsy for Common Femoral Artery Disease.Journal of clinical medicine · 2025Review
- Reply to "Enhancing PCI strategies for severely calcified coronary lesions: gaps and new directions".Heart and vessels · 2025Article
- Clinical outcomes of percutaneous coronary intervention for severely calcified lesions: comparison between the morphologies of severely calcified coronary lesions.Heart and vessels · 2025Article
- The Role of Calcified Nodules in Acute Coronary Syndrome: Diagnosis and Management.International journal of molecular sciences · 2025Review
- Prospective investigation of calcium score in optical coherence tomography-guided revascularization to identify lesions with low risk for stent under expansion: the CORAL study.Cardiovascular intervention and therapeutics · 2025Observational
- Calcified Coronary Artery Disease: Pathology, Prevalence, Predictors and Impact on Outcomes.Interventional cardiology (London, England) · 2025Review
- Quantitative evaluation of IVL: based on the tunica media gypsum calcification model and a prospective animal study.Frontiers in cardiovascular medicine · 2025Article
- Intracoronary Imaging for Calcium Modification: Intravascular Ultrasound and Optical Coherence Tomography.Interventional cardiology (London, England) · 2025Review
- Outcomes of coronary intravascular lithotripsy for the treatment of calcified nodules: a pooled analysis of the Disrupt CAD studies.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2024Article
Corrections and comments
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Authors and funding
13 authors at 11 institutions in 6 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary intravascular lithotripsy (IVL) safely facilitates successful stent implantation in severely calcified lesions. This analysis sought to determine the relative impact of lesion calcium eccentricity on the safety and effectiveness of IVL using high-resolution optical coherence tomography imaging.
methodsIndividual patient-level data (n=262) were pooled from 4 distinct international prospective studies (Disrupt CAD I, II, III, and IV) and analyzed by an independent optical coherence tomography core laboratory. IVL performance in eccentric versus concentric calcification was analyzed by dividing calcified lesions into quartiles (≤180° [most eccentric], 181°-270°, 271°-359°, and 360° [concentric]) by maximum continuous calcium arc.
resultsIn the 230 patients with clear imaging field on optical coherence tomography, there were no differences in preprocedure minimum lumen area, diameter stenosis, or maximum calcium thickness. The calcium length and volume index increased progressively with increasing mean and maximum continuous calcium arc (ie, concentricity). Conversely, the minimum calcium thickness decreased progressively with increasing concentricity. Post-procedure, the number of calcium fractures, fracture depth, and fracture width increased with increasing concentricity, with a 4-fold increase in the number of fractures in lesions with 360° of calcium arc compared with ≤180°. This increase in IVL-induced calcium fracture with increasing calcium burden and concentricity facilitated stent expansion and luminal gain such that there were no significant differences across quartiles.
conclusionsIVL induced calcium fractures proportional to the magnitude of coronary artery calcium, including in eccentric calcium, leading to consistent improvements in stent expansion and luminal gain in both eccentric and concentric calcified coronary lesions.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.