{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:08:26Z","timestamp":1778825306874,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"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":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Coronary artery disease (CAD) with severe calcification remains a growing challenge in percutaneous coronary intervention (PCI). Atherectomy (ATH) has long been used for plaque modification, whereas intravascular lithotripsy (IVL) has emerged as a promising alternative. Large\u2010scale comparative data on long\u2010term outcomes are limited.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n To compare 1\u2010year clinical outcomes, 30\u2010day procedural complications, and temporal trends between IVL and ATH use.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted a retrospective cohort study using the TriNetX Research Network, analyzing de\u2010identified data from 47 health care organizations. Adults with CAD undergoing single\u2010vessel PCI with drug\u2010eluting stent (DES) and either IVL or ATH were included. Outcomes were assessed after propensity matching, and annual utilization trends were evaluated from 2013 to 2024.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We identified 13,499 patients who underwent DES with IVL (\n n<\/jats:italic>\n \u2009=\u20097026) or ATH (\n n<\/jats:italic>\n \u2009=\u20096473). After matching, 5768 patients remained in each cohort. At 1 year, IVL was associated with lower risk of all\u2010cause mortality (RR 0.64; 95% CI 0.58\u22120.72;\n p<\/jats:italic>\n \u2009<\u20090.0001), myocardial infarction (RR 0.80; 95% CI 0.66\u22120.96;\n p<\/jats:italic>\n \u2009=\u20090.0166), and MACE (RR 0.71; 95% CI 0.62\u22120.82;\n p<\/jats:italic>\n \u2009<\u20090.0001). IVL also reduced 30\u2010day procedural complications (RR 0.77; 95% CI 0.61\u22120.97;\n p<\/jats:italic>\n \u2009=\u20090.0271), with less bleeding (RR 0.44; 95% CI 0.31\u22120.62;\n p<\/jats:italic>\n \u2009<\u20090.0001) and CA\u2010AKI (RR 0.71; 95% CI 0.55\u22120.91;\n p<\/jats:italic>\n \u2009=\u20090.0068). IVL use increased rapidly and surpassed ATH after 2022.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In this large, real\u2010world registry, IVL was associated with more favorable 1\u2010year outcomes and fewer 30\u2010day complications than ATH. These findings support IVL as a safe and effective alternative for complex coronary lesions, emphasizing the need for validation in randomized trials to assess for causality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ccd.70464","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T13:00:42Z","timestamp":1773666042000},"page":"1934-1944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intravascular Lithotripsy Is Associated With Superior Clinical Outcomes Compared to Atherectomy: A Large\u2010Scale, Propensity\u2010Matched Analysis"],"prefix":"10.1002","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7463-5127","authenticated-orcid":false,"given":"Charles D.","family":"Miks","sequence":"first","affiliation":[{"name":"Department of Internal Medicine University of Iowa Health Care Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grant K.","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Iowa Health Care Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chirayu R.","family":"Shukla","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of Iowa Health Care Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine University of Iowa Health Care Iowa USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-025-05022-x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.15420\/icr.2024.20"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.09.006"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.036531"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008434"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.09.603"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-20-1174"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jpm14040438"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2023.101259"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2025.06.075"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2024.01.012"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.31591"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.31664"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.30519"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29263"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2022.07.023"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2024.04.039"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2024.101259"}],"container-title":["Catheterization and Cardiovascular 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