{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T21:50:33Z","timestamp":1784929833955,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Calcification within chronic total occlusions (CTO) is strongly associated with worse outcomes. Despite the excellent success and safety of intravascular lithotripsy (IVL) in heavily calcified lesions, evidence in CTO remains scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study aimed to evaluate the procedural and long\u2010term clinical outcomes of IVL in heavily calcified CTO.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent IVL between 2019 and 2024 from an ongoing prospective multicenter registry were eligible for inclusion. Patients were therefore classified in CTO and non\u2010CTO groups. The efficacy and safety endpoints of CTO percutaneous coronary interventions were defined according to the CTO\u2010ARC consensus. In\u2010hospital major adverse cardiovascular events (MACE) included cardiac death, nonfatal myocardial infarction and target lesion revascularization (TVR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 404 patients underwent IVL, of which the treated lesion was a CTO in 33 (8.2%). The mean J\u2010CTO score was 2.3\u2009\u00b1\u20091.1. Device success showed no significant difference between CTO and non\u2010CTO groups (100% vs 98.4%; <jats:italic>p<\/jats:italic>\u2009=\u20090.35). Comparable technical success with residual stenosis &lt;30% was observed in both groups (90.1% in CTO vs 89.2% in non\u2010CTO, <jats:italic>p<\/jats:italic>\u2009=\u20090.83). The incidence of MACE was similar across groups during hospital stays (CTO 6.0% vs. non\u2010CTO 1.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.12), at 30\u2010day (CTO 9.1% vs. non\u2010CTO 3.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.07), and at 12\u2010month follow\u2010up (CTO 9.1% vs. non\u2010CTO 7.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.70).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IVL provides high procedural success and consistent clinical outcomes in both CTO and non\u2010CTO cases, reinforcing its role in managing heavily calcified coronary lesions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31207","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T08:49:36Z","timestamp":1724921376000},"page":"655-663","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intravascular lithotripsy in heavily calcified chronic total occlusion: procedural and one\u2010year clinical outcomes"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5946-0827","authenticated-orcid":false,"given":"Federico","family":"Oliveri","sequence":"first","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0860-6969","authenticated-orcid":false,"given":"Martijn J. H.","family":"van Oort","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibtihal","family":"Al Amri","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4986-8623","authenticated-orcid":false,"given":"Brian O.","family":"Bingen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1703-7921","authenticated-orcid":false,"given":"Bimmer E.","family":"Claessen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Amsterdam University Medical Center  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aukelien C.","family":"Dimitriu\u2010Leen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud University Medical Center  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joelle","family":"Kefer","sequence":"additional","affiliation":[{"name":"Department of Cardiology Saint\u2010Luc Bruxelles  Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hany","family":"Girgis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Jeroen Bosch Ziekenhuis Den\u2010Bosch The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessel","family":"Vossenberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medisch Centrum Leeuwarden  The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"van der Kley","sequence":"additional","affiliation":[{"name":"Department of Cardiology Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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