Sex-Specific Outcomes After Coronary Intravascular Lithotripsy: A Patient-Level Analysis of the Disrupt CAD Studies

•In this sex-based analysis of 629 patients (23% women) with severe coronary calcium undergoing intravascular lithotripsy, there was no difference in 30-day major adverse cardiovascular events between women and men (8.3% vs 7.1%, P = .61).•Successful stent delivery with residual in-stent stenosis ≤30% without in-hospital major adverse cardiovascular events was equally high in women and men (91.7% vs 92.6%, P = .72).•Unlike prior experience with atherectomy devices, serious angiographic complications (flow-limiting dissection, perforation, abrupt closure, slow flow, no reflow) were low for both women and men (1.6% vs 2.3%, P = .75).•Intravascular lithotripsy is safe and effective in treating severely calcified lesions in women as well as men, where other plaque modification atherectomy devices have resulted in more acute complications.