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Knowledge about the in-hospital safety of IVL in comparison to frequently used plaque modification techniques remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of this study was to assess the in-hospital outcomes of IVL in comparison to rotational atherectomy (RA) and cutting\/scoring balloons (C\/S).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 51,921 isolated PCI procedures of patients who underwent planned coronary angiography with IVL, RA or C\/S between 2019 and 2023 were extracted from a German nationwide registry. Analyses of the average treatment effect were carried out employing a double-robust estimator using machine learning algorithms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to IVL, adjusted procedural relative risk of in-hospital mortality was significantly higher for RA (RR 1.72; 95% CI: 1.24 \u2013 2.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and C\/S (RR 1.50; 95% CI: 1.08 \u2013 2.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015), while safety parameters such as stroke, severe bleeding and acute kidney injury were comparable. The adjusted risk of shock (RR 1.57; 95% CI: 1.20 \u2013 2.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and pericardial drainage (RR 1.95; 95% CI: 1.23 \u2013 3.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) was lower for IVL compared to RA but not to C\/S. Further, IVL use was associated with a shorter adjusted length of hospitalization compared to RA (\u2212\u20090.75\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and C\/S (\u2212\u20090.22\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IVL is associated with a favorable safety profile compared to RA and C\/S and a more timely discharge of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                    <jats:p>In-Hospital Outcomes of Intravascular Lithotripsy compared to Rotational Atherectomy and Cutting\/Scoring Balloon Angioplasty. AKIN: acute kidney injury, C\/S: Cutting\/Scoring balloon angioplasty, IVL: intravascular lithotripsy, RA: rotational atherectomy, RR: Relative Risk<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00392-026-02850-5","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T10:03:59Z","timestamp":1769594639000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["In-hospital outcomes of intravascular lithotripsy compared to rotational atherectomy and cutting\/scoring balloon angioplasty"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5249-0174","authenticated-orcid":false,"given":"Mark Colin","family":"Gissler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klaus","family":"Kaier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faridun","family":"Rahimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Bacmeister","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Rilinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas A.","family":"Heger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"J\u00e4ckel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Istv\u00e1n","family":"Bojti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timoteo","family":"Marchini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miroslaw","family":"Ferenc","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Westermann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziad A.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantin","family":"von zur M\u00fchlen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Maier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"issue":"5","key":"2850_CR1","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1161\/circulationaha.116.022061","volume":"134","author":"AJ Kirtane","year":"2016","unstructured":"Kirtane AJ, Doshi D, Leon MB et al (2016) Treatment of higher-risk patients with an indication for revascularization: evolution within the field of contemporary percutaneous coronary intervention. 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Ali reports institutional grants from Abbott, Abiomed, ACIST Medical, Boston Scientific, Cardiovascular Systems Inc., Medtronic, Opsens Medical, Philips, and Shockwave Medical; personal fees from Amgen, AstraZeneca, and Boston Scientific; and equity in Elucid, Lifelink, SpectraWAVE, Shockwave Medical, and VitalConnect. The other authors declare that there is no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}