Severely calcified coronary artery disease can cause reduced blood flow to the heart, leading to serious cardiac conditions. Intracoronary lithotripsy (ICL) has been developed to improve outcomes for patients with heavily calcified lesions. This study aims to summarize the existing evidence on the effectiveness and safety of intravascular lithotripsy (IVL) for severely calcified coronary artery disease.

We comprehensively searched PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus, from their inception up to April 1, 2023, with a restricted search strategy. The R version 4.2.3 was utilized using Metafor package for analysis. To determine the study's heterogeneity, the indices tau2 and I2, as well as Cochran's Q test, were employed.

A total of 17 studies, comprising 2488 observations, were included in the analysis. IVL is a treatment option for patients with severely calcified coronary artery disease. The percentage stenosis reduction showed a mean reduction of 15.0548% (95% CI: 8.310 to 21.79), with high heterogeneity observed among studies. The occurrence of cardiovascular-related events showed a proportion of 0.015 (95% CI: 0.0046-0.0254) and significant heterogeneity.

These findings suggest that IVL is an effective treatment option, but further studies are needed to better understand its efficacy and safety.