Procedural and clinical outcomes of coronary intravascular lithotripsy in patients with impaired renal function: a multicenter retrospective study

Phagu, A.A.S.; Oort, M.J.H. van; Oliveri, F.; Bingen, B.O.; Paradies, V.; Mincione, G.; ... ; Montero Cabezas, J.M. (2025)

Article / Letter to editor

Chronic kidney disease (CKD) is a prevalent comorbidity in patients undergoing percutaneous coronary intervention (PCI), yet its impact on outcomes following intravascular lithotripsy (IVL) remains insufficiently studied. This study evaluated procedural and long-term outcomes of IVL-assisted PCI in patients with renal insufficiency compared to those with normal renal function. From the BENELUX-IVL registry (May 2019 -September 2024), 558 patients were included in a retrospective multicenter analysis. Renal insufficiency was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) using the CKD-EPI formula. The primary endpoint was major adverse cardiovascular events (MACE) at one and two years of follow-up. Secondary endpoints included procedural, device, and technical success, as well as all-cause mortality. Multivariable logistic regression was used to identify independent predictors of mortality. A total of 586 lesions were treated in 558 patients: 190 (32.4%) with renal insufficiency and 396 (67.6%) with normal renal function. One-year MACE occurred in 14 (13.3%) versus 28 (10.9%) patients (p = 0.80), and between year one and two in 4 (5.6%) versus 5 (2.8%) patients (p = 0.46). Procedural success was similar between groups (88.6% versus 88.7%; p = 0.97). All-cause mortality was higher in the renal insufficiency group (n = 32, 18.2% versus n = 44, 11.5%; p = 0.03). On multivariable analysis, eGFR was independently associated with mortality (OR 0.98; 95% CI 0.97-1.00; p = 0.020). In conclusion, IVL-assisted PCI resulted in similar procedural and MACE outcomes regardless of renal function, although mortality was significantly higher in patients with renal insufficiency. (c) 2025 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

• intravascular lithotripsy (IVL)
• percutaneous coronary intervention (PCI)
• renal insufficiency
• chronic kidney disease (CKD)
• major adverse cardiovascular events (MACE)
• all-cause mortality

• All authors: Phagu, A.A.S.; Oort, M.J.H. van; Oliveri, F.; Bingen, B.O.; Paradies, V.; Mincione, G.; Claessen, B.E.P.M.; Dimitriu-Leen, A.C.; Vossenberg, T.N.; Kefer, J.; Mandurino-Mirizzi, A.; Kley, F. van der; Jukema, J.W.; Amri, I. al; Montero Cabezas, J.M.
• Date: 2025-08-19
• Journal: The American Journal of Cardiology
• Volume: 256
• Pages: 72 - 80
• DOI: doi:10.1016/j.amjcard.2025.07.023