{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:49:04Z","timestamp":1791917344906,"version":"4.3.4"},"reference-count":18,"publisher":"Sociedade Brasileira de Cardiologia","issue":"8","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamento  A litotripsia intravascular (IVL) surgiu como uma tecnologia inovadora para o tratamento de les\u00f5es coron\u00e1rias calcificadas.  Objetivo  Avaliar se a sele\u00e7\u00e3o de casos e o desempenho intervencionista com a IVL evolu\u00edram ao longo do tempo ap\u00f3s sua incorpora\u00e7\u00e3o \u00e0 pr\u00e1tica cl\u00ednica.  M\u00e9todos  Inclu\u00edmos prospectivamente 104 pacientes consecutivos com 127 les\u00f5es coron\u00e1rias calcificadas tratadas por meio da IVL. A coorte foi dividida em dois grupos temporais (52 pacientes cada), com base na ordem de inclus\u00e3o dos pacientes. Dados cl\u00ednicos e o desempenho do procedimento foram comparados entre os grupos. Todos os testes estat\u00edsticos foram bicaudais, com n\u00edvel de signific\u00e2ncia de 0,05.  Resultados  A idade m\u00e9dia foi de 73,2 \u00b1 10,2 anos e 62,5% dos pacientes apresentavam s\u00edndromes coron\u00e1rias agudas. Foram identificadas calcifica\u00e7\u00e3o grave e les\u00f5es do tipo B2\/C em 73,2% e 98,4% dos casos, respectivamente. A IVL foi realizada como estrat\u00e9gia inicial em 92,9% das les\u00f5es; utilizou-se imagem intravascular em 78% dos casos e aterectomia rotacional em 6,3%, sendo obtido sucesso angiogr\u00e1fico em 96,0%. Em compara\u00e7\u00e3o com a primeira coorte, a segunda apresentou mais les\u00f5es em bifurca\u00e7\u00e3o (60,0% vs. 41,9%; p = 0,04), mais interven\u00e7\u00f5es na art\u00e9ria circunflexa (24,6% vs. 8,1%; p = 0,02) e menor uso de bal\u00f5es com 4,0 mm de di\u00e2metro (4,6% vs. 18,5%; p = 0,02). A segunda coorte abrangeu um per\u00edodo de inclus\u00e3o mais longo (168 \u00b1 90,8 vs. 120 \u00b1 72,8 dias; p = 0,004) e apresentou menos complica\u00e7\u00f5es angiogr\u00e1ficas (1,5% vs. 14,5%; p = 0,01), enquanto a incid\u00eancia de eventos card\u00edacos adversos maiores intra-hospitalares n\u00e3o diferiu (3,8% vs. 5,8%; p = 1,0).  Conclus\u00e3o  A IVL \u00e9 uma modalidade eficaz para a modifica\u00e7\u00e3o do c\u00e1lcio coron\u00e1rio. As mudan\u00e7as temporais na sele\u00e7\u00e3o de casos e no desempenho intervencionista podem refletir uma curva de aprendizado e adapta\u00e7\u00e3o.<\/jats:p>","DOI":"10.36660\/abc.20250783","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:36:40Z","timestamp":1791916600000},"source":"Crossref","is-referenced-by-count":0,"title":["Incorpora\u00e7\u00e3o da Litotripsia Intracoron\u00e1ria na Pr\u00e1tica Cl\u00ednica: Uma An\u00e1lise Comparativa Temporal de Seguran\u00e7a, Efic\u00e1cia e Curva de Aprendizado"],"prefix":"10.36660","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6942-355X","authenticated-orcid":false,"given":"Guy F. 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Claudia","family":"Conrado","sequence":"additional","affiliation":[{"name":"Hospital Israelita Albert Einstein","place":["S\u00e3o Paulo, SP, Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Silveira","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Universitario do Porto","place":["Porto, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0050-5178","authenticated-orcid":false,"given":"Emanuele","family":"Barbato","sequence":"additional","affiliation":[{"name":"University of Rome La Sapienza","place":["Rome, It\u00e1lia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6662-0304","authenticated-orcid":false,"given":"Flavio","family":"Ribichini","sequence":"additional","affiliation":[{"name":"Universita degli Studi di Verona","place":["Verona, 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