ArticleHeart and vessels2026
Association between intimal thickness of superficial calcified sheet and calcium fracture after intravascular lithotripsy.
Article in Heart and vessels, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The association between intimal thickness of the superficial calcific sheet and calcium fracture after intravascular lithotripsy (IVL) during percutaneous coronary intervention (PCI) remains unclear. This study aimed to investigate the association between intimal thickness of the superficial calcific sheet and calcium fracture after IVL in PCI. Among 40 consecutive PCIs with IVL, 24 lesions from 23 PCIs in 21 patients with complete pre-IVL, post-IVL, and final post-stenting optical coherence tomography (OCT) or optical frequency domain imaging (OFDI) were analyzed. Cross sections with eruptive calcified nodules or calcified protrusions were excluded. In total, 357 cross-sectional OCT/OFDI segments of superficial calcific sheet were analyzed at 1-mm longitudinal intervals. Maximum intimal thickness was defined as the thickest intima of the superficial calcific sheet. Segments with calcium fracture after IVL had a thinner maximum intimal thickness compared with those without fracture (0.27 [0.16-0.38] mm vs. 0.38 [0.23-0.54] mm, p < 0.001). Receiver operating characteristic analysis of maximum intimal thickness for calcium fracture showed an AUC of 0.64 with a cutoff of 0.34 mm. Based on this cutoff, 198 segments were classified as the thin intimal thickness group (≤ 0.34 mm) and 159 as the thick intimal thickness group (> 0.34 mm). Thin intimal thickness was independently associated with calcium fracture (OR = 2.70, 95% CI 1.60-4.56, p < 0.001), after adjusting for calcium angle and minimum calcium thickness. Thin intimal thickness of the superficial calcific sheet was positively associated with calcium fracture after IVL.
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