TCT 2025 - The randomized VICTORY Study finds OCT-guided PCI involving lesion preparation with the OPN super-high-pressure non-compliant balloon is non-inferior to intravascular lithotropsy.

Dr Matthias Bossard (Kantonsspital Lucerne, Lucerne, CH) joins us to discuss findings from the VICTORY Trial, a randomized, multicenter, non-inferiority comparison evaluating intravascular lithotripsy versus super-high-pressure non-compliant balloons for treatment of calcified and refractory coronary lesions.

This prospective trial randomized 280 patients with heavily calcified coronary lesions requiring stent implantation to receive lesion preparation with either the Shockwave intravascular lithotripsy balloon catheter or the OPN super-high-pressure non-compliant balloon. Both strategies were followed by drug-eluting stent placement, with treatment guided by optical coherence tomography to assess final stent expansion and procedural outcomes.

Key findings showed no difference in the primary outcome of stent expansion percentage between the OPN NCB and IVL. Subgroup analyses consistently indicated non-inferiority of the OPN NCB compared to IVL in heavily calcified lesions. In terms of safety, there was no significant difference for major periprocedural complications.

Interview Questions: 

1. What are the current challenges in treating heavily calcified coronary lesions, and how do super-high-pressure balloons and intravascular lithotripsy address these challenges?
2. Could you outline the design and primary objectives of the VICTORY Trial?
3. What were your key findings?
4. Were there any notable differences in safety profiles?
5. How might these findings influence device selection and treatment algorithms for calcified lesions in clinical practice?
6. What are the next steps for this research, and what future questions remain regarding optimal lesion preparation strategies?

Recorded onsite at TCT 2025, San Francisco.

Editor: Jordan Rance
Videographer: Mike Knight, Tom Green
Support: This is an independent interview produced by Radcliffe Cardiology.