{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:50:55Z","timestamp":1791391855684,"version":"4.3.3"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>IVL is increasingly used for coronary calcium modification; however, prospective data for its use in LMS lesions are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the feasibility, safety, and mechanical efficacy of intravascular lithotripsy (IVL) for calcium modification in calcified distal left main stem (LMS) percutaneous coronary intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, multicentre, open\u2010label study across five United Kingdom centers (NCT04319666), 50 patients with obstructive distal LMS disease and IVUS\u2010confirmed circumferential calcification (maximum calcium arc \u2265\u2009270\u00b0 in at least one segment) underwent IVL\u2010assisted PCI. IVUS was mandated at pre\u2010treatment, post\u2010IVL, and post\u2010stent timepoints with independent core laboratory analysis. Co\u2010primary endpoints were IVUS\u2010assessed minimum stent area (MSA) and 30\u2010day major adverse cardiac events (MACE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty patients underwent IVUS\u2010guided LMS PCI with IVL for calcium modification. Device crossing was successful in all 50 cases. Mean LMS MSA was 13.36\u2009\u00b1\u20093.20\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      (95% CI 12.44\u201314.28\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      ); 84% of patients (41\/49) achieved an LMS MSA exceeding 11\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      . Significant luminal gain was observed across all territories (LMS 7.19\u2009\u00b1\u20093.52\u2009mm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). IVUS\u2010visible calcium fracture was not associated with stent expansion. There were no periprocedural deaths or myocardial infarctions and no MACE at 30 days. At 12 months, MACE occurred in 4 patients (8.0%) with no stent thrombosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IVL is safe and mechanically efficacious for calcium modification in severely calcified distal LMS disease, achieving stent expansion exceeding prognostically validated thresholds with favorable clinical outcomes at 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n                      NCT04319666.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70927","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:56:22Z","timestamp":1791388582000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intravascular Lithotripsy in Left Main Stem Percutaneous Coronary Intervention"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1754-4680","authenticated-orcid":false,"given":"Claudia S","family":"Cosgrove","sequence":"first","affiliation":[{"name":"City St George's University of London London UK"},{"name":"St George's University Hospital Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7424-0419","authenticated-orcid":false,"given":"Retesh","family":"Bajaj","sequence":"additional","affiliation":[{"name":"St Michael's Hospital Unity Health Toronto Toronto Canada"},{"name":"Li Ka Shing Knowledge Institute University of 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