{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T07:00:41Z","timestamp":1771225241686,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T00:00:00Z","timestamp":1754611200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Stent underexpansion from severe calcification leads to adverse outcomes. While intravascular lithotripsy (IVL) is effective pre\u2010stenting, its role in treating stent underexpansion remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter, retrospective study of patients undergoing percutaneous coronary intervention (PCI) with IVL from January 2019 to 2025. Patients were categorized into two groups based on IVL use: the upfront group (IVL before stent placement) and the intrastent group (IVL for treating stent underexpansion). The outcomes included a quantitative flow ratio\u2010based trans\u2010stent gradient (QFR\u2010TSG)\u2009&gt;\u20090 post\u2010PCI, target vessel failure, and major adverse cardiovascular events (MACE). Statistical analyses employed inverse probability of treatment weighting with logistic and Cox regression models and Kaplan\u2212Meier survival curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 166 consecutive patients were included, with 79 (47.6%) in the intrastent IVL group and 87 (52.4%) in the upfront IVL group. Compared to the upfront IVL group, patients treated with intrastent IVL had a higher prevalence of diabetes mellitus (49.4% vs. 19.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). QFR\u2010TSG\u2009&gt;\u20090 was significantly more frequent in the intrastent IVL group (77.2% vs. 60.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.036). After IPTW adjustment, intrastent IVL was not significantly associated with increased MACE risk (OR 1.11; 95% CI 0.55\u20132.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.240). Kaplan\u2212Meier analysis similarly showed no difference in MACE\u2010free survival between groups over a mean follow\u2010up of 3.7 years (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.299).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intrastent IVL yields inferior functional results versus upfront IVL but appears safe and may serve as a useful rescue option for stent underexpansion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70086","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T10:25:05Z","timestamp":1754648705000},"page":"2469-2476","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional Assessment of Intravascular Lithotripsy for Stent Underexpansion"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9198-2600","authenticated-orcid":false,"given":"Jacopo","family":"Farina","sequence":"first","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5294-3682","authenticated-orcid":false,"given":"Sant","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Cardiology Creighton University School of Medicine Omaha Nebraska USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-188X","authenticated-orcid":false,"given":"Gianluca","family":"Campo","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Biscaglia","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Zuin","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6115-5822","authenticated-orcid":false,"given":"Stefano","family":"Andreaggi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5916-8882","authenticated-orcid":false,"given":"Roberto","family":"Scarsini","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division 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Verona Verona Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-5292","authenticated-orcid":false,"given":"Andrea","family":"Erriquez","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara 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