ELLIS Study: Comparative Analysis of Excimer Laser Coronary Angioplasty and Intravascular Lithotripsy on Drug-Eluting Stent as Assessed by Scanning Electron Microscopy

• DOI: 10.1161/circinterventions.124.014505
• Publication Date: 2024-10-18T09:00:27Z
• Authors: Borja Rivero-Santana; Carlos Galán; Claudia Pérez-Mar...; Borja Ibañez; Armando Pérez de ...; María Fernández-V...; Raúl Moreno; Alfonso Jurado-Roman
• Keywords: Intravascular Ultrasound; Interventional cardiology; Excimer

BACKGROUND: Stent underexpansion is a significant challenge in percutaneous coronary intervention, critically impacting patient outcomes. While excimer laser angioplasty (ELCA) and intravascular lithotripsy (IVL) are increasingly used to address this issue, their full impact on the integrity of drug-eluting stents remains unclear, raising concerns about safety efficacy. METHODS: This vitro study assessed effects ELCA IVL structural using scanning electron microscopy. Nine stents, 5 Onyx Frontier (with durable circumferential polymer coating) 4 Cre8 (polymer-free), were implanted 3-dimensional artery simulator following standardized protocols. After implantation, treatments with saline-ELCA, contrast-ELCA, IVL, high-pressure balloon dilatation applied. A comprehensive evaluation stent surface was performed at 60-fold magnification. RESULTS: Scanning microscopy analysis revealed differences damage between techniques. High-pressure contrast-ELCA exhibited substantial fragmentation detachment compared conventional dilatation. demonstrated highest incidence shaving overcoating. No alterations observed polymer-free regardless technique used. CONCLUSIONS: saline-ELCA applied immediately after implantation produce minimal damage, whereas cause coating. The appears stable Further research needed validate these findings explore clinical implications.