Dual-Prep registry: atherectomy devices and intravascUlAr lithotripsy for the PREParation of heavily calcified coronary lesions registry

• DOI: 10.1007/s12928-025-01130-9
• Publication Date: 2025-05-12T07:19:03Z
• Authors: Masato Nakamura; Nehiro Kuriyama; Yutaka Tanaka; Seiji Yamazaki; Tomohiro Kawasaki; Takashi Muramatsu; Kazushige Kadota; Takashi Ashikaga; Akihiko Takahashi; Satoru Otsuji; Kenji Ando; Masaru Ishida; Shigeru Nakamura; Yoshiaki Ito; Raisuke Iijima; Gaku Nakazawa; Junya Shite; Junko Honye; Junya Ako; Hiroyoshi Yokoi; Ken Kozuma; Hiromasa Otake; Kazuho Masumura; Tomomi Yamada; Yohei Sotomi
• Keywords: Mace; Atherectomy; Intravascular Ultrasound; Interventional radiology; Clinical endpoint

Abstract Evaluation of calcified lesions by intravascular imaging has revealed that atherectomy devices have only limited impact. However, subsequent use coronary lithotripsy (IVL) may increase treatment effectiveness without increasing risk complications. This study was designed to evaluate the safety and IVL after in severely as pre-treatment for drug-eluting stents (DES). The Dual-Prep registry is a multicenter, prospective consecutive image-guided percutaneous interventions (PCI). primary endpoints were procedural success (residual stenosis < 50% quantitative angiography) an in-hospital major adverse cardiac event (MACE) 30-day freedom from MACE, respectively. Baseline vessel calcification score final DES expansion evaluated optical coherence tomography (OCT). A total 118 patients with 120 enrolled at 20 sites. core-lab assessment 4.0 all cases. Rotational applied prior 83.9% cases mean burr size 1.57 ± 0.20 mm; subsequently successfully delivered (mean balloon diameter 3.02 0.45 mm), followed deployment 3.19 0.51 mm, length 36.3 16.0 mm). efficacy met 98.3% cases, index 0.8 seen 42.2%, eccentricity 0.7 not observed any patient. In lesions, lesion preparation demonstrated high rates satisfactory non-eccentric stent expansion. approach be considered where ‘IVL-first’ strategy feasible. jRCT1032230384 (Oct 7, 2023). Graphical abstract : + before implantation (Calc ≥ 3 atherectomy)