Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
July 28, 2026 · via Europe PMC
Calcified Plaque Detachment: Alternative Calcified Plaque Modification After Coronary Intravascular Lithotripsy.
Naito D, Matsuo A, Kasahara T, Ota K, Matsunaga S, Nakajima N.
AI summary — for doctors, generated from the abstract only
Calcified plaque detachment from the vessel wall was common after coronary intravascular lithotripsy and appeared safe, suggesting it may contribute to plaque modification alongside calcium fracture.
What was studied
Optical coherence tomography assessment of calcified plaque immediately after IVL in 45 consecutive patients, comparing those with and without detachment (partial or complete separation from intima or media).
Key findings
- Detachment occurred in 22 patients (49%) with no major dissection, intramural hematoma or slow flow, while calcium fracture occurred in 35 (78%)
- Stent expansion index did not differ significantly between groups (77.6% vs 83.2%, p = 0.17)
- With greater calcium arc grades, detachment became less frequent (p = 0.01) and fracture more frequent (p = 0.02)
Clinical relevance
Interventionalists using IVL may see detachment on OCT and can recognise it as a frequent, apparently benign way calcium is modified, particularly in lesions with smaller calcium arcs.
Who should care
Limitations
Small single-centre OCT series with no clinical outcomes, no demonstrated difference in stent expansion, and no comparison against non-IVL strategies.
Detachment is a frequent, safe-appearing mechanism after IVL, but whether it improves stent results remains unproven.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Calcified plaque (CP) detachment (CD) and calcium fracture (CF) can occur following coronary intravascular lithotripsy (IVL). The extent to which CF alone facilitates stent expansion during CP modification with IVL remains unclear.
Aims
This study aimed to investigate the clinical implications of IVL-induced CD.
Methods
Optical coherence tomography was performed to assess coronary CP immediately after IVL in 45 consecutive patients for whom images were available. CD was defined as partial or complete separation of the CP from either the coronary artery intima or media. The study population was divided into CD and non-CD groups.
Results
CD was observed in 22 patients (49%) without associated major dissection, intramural hematoma, or slow flow, whereas CF was observed in 35 patients (78%). No significant differences were found in baseline characteristics between the groups. The stent expansion index was not significantly different between the groups (77.6% vs. 83.2%, p = 0.17). Across increasing calcium arc grades, CD frequency decreased significantly (p = 0.01), whereas CF frequency increased (p = 0.02).
Conclusions
CD frequently occurs in patients undergoing coronary IVL, with CP separation from the vessel wall proceeding safely and without coronary flow impairment. In addition to CF, CD may contribute to CP modification, facilitating lumen enlargement and successful stent deployment.
DOI
10.1002/ccd.70764
PMID
42517310
PMCID
PMC13667323
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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