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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Clinical Outcomes of Intravascular Lithotripsy in Diabetic Patients with Stent Failure: Insights from the COIL Registry

  • Michał Kuzemczak1,2,3
  • Janusz Lipiecki4
  • Jacek Legutko5,6
  • Johan Bennett7
  • Joseph Dens8
  • Mohammad Alkhalil9,10
10 affiliations
  1. 1Division of Emergency Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland
  2. 2Department of Internal Diseases and Cardiology, Medical University of Warsaw, 02-005 Warsaw, Poland
  3. 3Department of Interventional Cardiology and Internal Diseases, Military Institute of Medicine—National Research Institute, 05-119 Legionowo, Poland
  4. 4Centre de Cardiologie Interventionnelle, Pôle Santé République, 63100 Clermont-Ferrand, France
  5. 5Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, 31-202 Cracow, Poland
  6. 6Clinical Department of Interventional Cardiology, The Saint John Paul II Hospital, 31-202 Cracow, Poland
  7. 7Department of Cardiovascular Medicine, KU Leuven, University Hospitals Leuven, 3000 Leuven, Belgium
  8. 8Ziekenhuis Oost-Limburg, 3600 Genk, Belgium
  9. 9Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne NE7 7DN, UK
  10. 10Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne NE1 7RU, UK
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Abstract

Background/Objectives: Although still considered off-label, there are accumulating data demonstrating that intravascular lithotripsy (IVL) is safe and effective in treating patients with stent failure (SF). Diabetes (DM) is an independent predictor of recurrent SF. Whether IVL has a differential treatment effect depending on the diabetic status of SF patients undergoing IVL has never been studied. Therefore, we aimed to compare IVL outcomes in patients with SF and concomitant DM versus non-DM counterparts. Methods: This is a pre-specified subgroup analysis of the COIL registry (coronary intravascular lithotripsy in patients with stent failure), which included patients who underwent IVL for SF, divided according to the patients’ diabetic status. Procedural and clinical outcomes were compared between DM and non-DM patients. The primary clinical endpoint was major adverse clinical event (MACE) defined as the composite of cardiovascular death, spontaneous myocardial infarction, or target vessel revascularization (TVR) at one-year follow-up. Results: There were 102 patients enrolled in the coronary intravascular lithotripsy in patients with stent failure (COIL) registry, of whom 47 (46.1%) had DM. Most baseline clinical characteristics were similar between the groups, although patients with DM had higher rates of hypertension and hypercholesterolemia. The use of intracoronary imaging (53% and 56%, respectively, p = 0.75) and the procedural success rate (77% vs. 80%, p = 0.68) were similar in DM and non-DM patients. No difference was observed in the incidence of in-hospital (2.1% vs. 1.8%, p = 0.91) and one-year MACE (12.8% vs. 18.2%, p = 0.45). Conclusions: In patients undergoing IVL for the treatment of SF, procedural and one-year clinical outcomes did not differ significantly between DM and non-DM patients, although the limited sample size should be acknowledged.

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Cite

BibTeXRIS
BibTeX
@article{kuzemczak2026clinical,
  title = {{Clinical Outcomes of Intravascular Lithotripsy in Diabetic Patients with Stent Failure: Insights from the COIL Registry}},
  author = {Michał Kuzemczak and Janusz Lipiecki and Jacek Legutko and Johan Bennett and Joseph Dens and Mohammad Alkhalil},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218330},
  url = {https://www.mdpi.com/2077-0383/15/21/8330},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Clinical Outcomes of Intravascular Lithotripsy in Diabetic Patients with Stent Failure: Insights from the COIL Registry
AU  - Michał Kuzemczak
AU  - Janusz Lipiecki
AU  - Jacek Legutko
AU  - Johan Bennett
AU  - Joseph Dens
AU  - Mohammad Alkhalil
PY  - 2026
DA  - 2026/10/26
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218330
UR  - https://www.mdpi.com/2077-0383/15/21/8330
AB  - Background/Objectives: Although still considered off-label, there are accumulating data demonstrating that intravascular lithotripsy (IVL) is safe and effective in treating patients with stent failure (SF). Diabetes (DM) is an independent predictor of recurrent SF. Whether IVL has a differential treatment effect depending on the diabetic status of SF patients undergoing IVL has never been studied. Therefore, we aimed to compare IVL outcomes in patients with SF and concomitant DM versus non-DM counterparts. Methods: This is a pre-specified subgroup analysis of the COIL registry (coronary intravascular lithotripsy in patients with stent failure), which included patients who underwent IVL for SF, divided according to the patients’ diabetic status. Procedural and clinical outcomes were compared between DM and non-DM patients. The primary clinical endpoint was major adverse clinical event (MACE) defined as the composite of cardiovascular death, spontaneous myocardial infarction, or target vessel revascularization (TVR) at one-year follow-up. Results: There were 102 patients enrolled in the coronary intravascular lithotripsy in patients with stent failure (COIL) registry, of whom 47 (46.1%) had DM. Most baseline clinical characteristics were similar between the groups, although patients with DM had higher rates of hypertension and hypercholesterolemia. The use of intracoronary imaging (53% and 56%, respectively, p = 0.75) and the procedural success rate (77% vs. 80%, p = 0.68) were similar in DM and non-DM patients. No difference was observed in the incidence of in-hospital (2.1% vs. 1.8%, p = 0.91) and one-year MACE (12.8% vs. 18.2%, p = 0.45). Conclusions: In patients undergoing IVL for the treatment of SF, procedural and one-year clinical outcomes did not differ significantly between DM and non-DM patients, although the limited sample size should be acknowledged.
SN  - 2077-0383
ER  -