Critical calcified carotid stenosis treated with shockwave lithoplasty

Grillo, Placido; Tripolino, Cesare; Tassone, Eliezer Joseph; Morabito, Gaetano; Missiroli, Bindo

doi:10.5114/amsad.2018.81010

Cited by 13 publications

(9 citation statements)

References 5 publications

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“…The fractured or compressed calcium remains confined within the vessel lining. Given the mechanism of action and the reported safety and effectiveness of IVL, successful use of IVL for calcium modification has facilitated other procedures, including transfemoral passage of large-bore aortic valve delivery systems 16,17 and stent placement in calcified carotid arteries, 18 as well as treatment of stent underexpansion due to severe coronary calcification. [19][20][21] Limitations First, the Disrupt PAD III Observational Study is a singlearm study without a control group and thus no definitive comparisons can be made to other interventions regarding safety and effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Intravascular Lithotripsy for Treatment of Calcified Lower Extremity Arterial Stenosis: Initial Analysis of the Disrupt PAD III Study

et al. 2020

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Purpose: To evaluate the performance of peripheral intravascular lithotripsy (IVL) in a real-world setting during endovascular treatment of multilevel calcified peripheral artery disease (PAD). Materials and Methods: The Disrupt PAD III Observational Study ( ClinicalTrials.gov identifier NCT02923193) is a prospective, nonrandomized, multicenter, single-arm observational study assessing the acute safety and effectiveness of the Shockwave Peripheral IVL System for the treatment of calcified, stenotic lower limb arteries. Patients were eligible if they had claudication or chronic limb-threatening ischemia and moderate or severe arterial calcification. Between November 2017 and August 2018, 200 patients (mean age 72.5±8.7 years; 148 men) were enrolled across 18 sites and followed through hospital discharge. Results: In the 220 target lesions, IVL was more commonly used in combination with other balloon-based technologies (53.8%) and less often with concomitant atherectomy or stenting (19.8% and 29.9%, respectively). There was a 3.4-mm average acute gain at the end of procedure; the final mean residual stenosis was 23.6%. Angiographic complications were rare, with only 2 type D dissections and a single perforation following drug-coated balloon inflation (unrelated to the IVL procedure). There was no abrupt closure, distal embolization, no reflow, or thrombotic event. Conclusion: Use of peripheral IVL to treat severely calcified, stenotic PAD in a real-world study demonstrated low residual stenosis, high acute gain, and a low rate of complications despite the complexity of disease.

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Section: Discussionmentioning

confidence: 99%

Intravascular Lithotripsy for Treatment of Calcified Lower Extremity Arterial Stenosis: Initial Analysis of the Disrupt PAD III Study

et al. 2020

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“…77 Finally, IVL technology might be a new and effective tool for the management of calcified stenosis, including the carotid and innominate district, allowing better stent delivery and expansion. 78,79…”

Section: Discussion—authors’ Perspectivesmentioning

confidence: 99%

Shockwave Intravascular Lithotripsy for the Treatment of Severe Vascular Calcification

et al. 2020

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Vascular calcification is a highly prevalent pathophenotype that is associated with aging, atherosclerotic cardiovascular disease, diabetes mellitus, and chronic kidney disease. When present, it portends a worse clinical outcome and predicts major adverse cardiovascular events. Heavily calcified coronary and peripheral artery lesions are difficult to dilate appropriately with conventional balloons during percutaneous intervention, and the use of several adjunctive strategies of plaque modification has been suggested. Intravascular lithotripsy (IVL) offers a novel option for lesion preparation of severely calcified plaques in coronary and peripheral vessels. It is unique among all technologies in its ability to modify calcium circumferentially and transmurally, thus modifying transmural conduit compliance. In this article, we summarize the currently available evidence on this technology, and we highlight its best clinical application through appropriate patient and lesion selection, with the main objective of optimizing stent delivery and implantation, and subsequent improved short- and long-term outcomes. We believe that the IVL balloon will transform the market, as it is easy to use, with predictable results. However, cost-effectiveness of such advanced technology will need to be considered.

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“…For these reasons, having an effective tool able to improve luminal gain without compromising procedural safety can offer novel opportunities in CAS procedures. Only two cases of CAS using S‐IVL for vessel preparation have been reported in literature so far 9,10 . The system is based on a novel technology that integrates angioplasty balloon catheter devices with the calcium‐disrupting power of sonic pressure waves and has the unique feature of being highly tissue‐selective.…”

Section: Discussionmentioning

confidence: 99%

“…Only two cases of CAS using S-IVL for vessel preparation have been reported in literature so far. 9,10 The system is based on a novel technology that integrates angioplasty balloon catheter devices with the calcium-disrupting power of sonic pressure waves and has the unique feature of being highly tissue-selective. It means that sonic waves pass through the balloon and soft vascular tissue without interacting with those, to selectively disrupt calcium.…”

Section: Casementioning

confidence: 99%

Shockwave intravascular lithoplasty for the treatment of calcified carotid artery stenosis: A very early single‐center experience

Vadalà

Galassi

Nerla

et al. 2020

Cathet Cardio Intervent

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Critical calcified carotid stenosis treated with shockwave lithoplasty

Cited by 13 publications

References 5 publications

Intravascular Lithotripsy for Treatment of Calcified Lower Extremity Arterial Stenosis: Initial Analysis of the Disrupt PAD III Study

Intravascular Lithotripsy for Treatment of Calcified Lower Extremity Arterial Stenosis: Initial Analysis of the Disrupt PAD III Study

Shockwave Intravascular Lithotripsy for the Treatment of Severe Vascular Calcification

Shockwave intravascular lithoplasty for the treatment of calcified carotid artery stenosis: A very early single‐center experience

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