Use of Shockwave Intravascular Lithotripsy for the Treatment of Calcified Renal Artery Stenosis in a Symptomatic Subject

Schnupp, Steffen; Ajmi, Issameddine; Sinani, Muhamet; Brachmann, Johannes; Mahnkopf, Christan

doi:10.2217/fca-2019-0051

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…14 Schnupp S et al described treatment of a critical renal artery stenosis by predilating with a plain balloon, followed by IVL for lesion modification. 15 In all three cases, the lesion was stented after dilation. Di Palma G et al showed that the IVL system can also be used to modify a calcified in-stent restenosis of a bare metal stent in the renal artery.…”

Section: Discussionmentioning

confidence: 94%

“…Other authors have also reported the treatment of similar lesions or in-stent restenosis in the renal artery with IVL. [13][14][15][16] Lee D et al demonstrated a case of successful dilation of a bilateral renal artery stenosis with the IVL system after unsuccessful plain balloon and cutting balloon angioplasty. 13 Yousif N et al used the IVL system to dilate heavily calcified lesions in both renal arteries, without prior dilation.…”

Section: Discussionmentioning

confidence: 99%

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Use of Intravascular Lithotripsy in Heavily Calcified Renal Artery Stenosis: A Case Report

Vancampenhout

Kerselaers

Aerden

et al. 2022

Vasc Endovascular Surg

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Heavily calcified arterial lesions are difficult to treat in an endovascular manner with conventional techniques due to limited arterial compliance. Intravascular lithotripsy offers a novel minimally invasive therapeutic option through endovascular emission of acoustic waves, fracturing calcium deposits and facilitating lesion dilation. We present the case of a successful application of the Shockwave intravascular lithotripsy system (IVL®, Shockwave Medical Inc) in a heavily calcified stenosis of the right renal artery in a patient with a coral reef aorta.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Use of Intravascular Lithotripsy in Heavily Calcified Renal Artery Stenosis: A Case Report

Vancampenhout

Kerselaers

Aerden

et al. 2022

Vasc Endovascular Surg

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“…3 As reported by Sakorafas, 1 the symptoms are associated with a reduction of the blood flow higher than 60% to 75%, and in this series, all cases ranged from 70% 8 to over 90%, as in the present case, and in the SMA 11 and right renal artery. 14 In this case series, the most commonly used IVL balloons are those measuring 4 mm × 40 mm for renal arteries (with shorter lesions) and 6 mm × 60 mm for celiac mesenteric arteries (longer lesions). In our case, we used a wider balloon (8 mm × 60 mm), without damaging the vessel.…”

Section: Discussionmentioning

confidence: 96%

“…Since 2020, 7 studies (all case reports) 8,9,11 –15 on this topic have been published, with an overall number of 9 patients and 11 vessels treated. The most treated vessel was the SMA in 37% of cases, and the most common diagnosis was CMI in 6 of 9 patients.…”

Section: Discussionmentioning

confidence: 99%

Use of Shockwave Intravascular Lithotripsy in Recanalization of Calcified Visceral and Renal Arteries: A Case Report and Update of the Literature

et al. 2022

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Purpose Calcifications of the visceral and renal arteries lead to chronic mesenteric ischemia and renal artery stenosis, and both open and endovascular treatments can be proposed. Intravascular lithotripsy (IVL) has emerged as a novel technique used in peripheral and coronary interventions. Case Report A 73-year-old man presented with chronic postprandial abdominal pain and weight loss. Computed-tomography-angiography (CTA) showed 93% calcified stenosis of the superior mesenteric artery (SMA). The plain old balloon angioplasty (POBA) was affected by immediate recoiling. The patient underwent ShockwaveTM IVL of the SMA via brachial access and stent-graft implantation. At 3-months follow-up, the patient showed symptoms resolution. Conclusions The use of Shockwave IVL can be an effective treatment for severely calcified SMA stenosis. A similar approach can be employed in both celiac and renal arteries as reported in 11 cases in literature and herein summarized. Intravascular lithotripsy resulted in high technical success and uneventful follow-up. However, given the small number of patients reported, larger studies are needed to confirm these findings. Clinical Impact This article reports a case of recanalization of superior mesenteric artery with heavily calcified lesion treated with intravascular lithotripsy (IVL) with Shockwave™ Intravascular Lithotripsy Balloon (Shockwave Medical Inc., Santa Clara, CA, USA). Beside, for the first time, we summarize the Literature on the use of IVL in the renal and visceral arteries district, providing indications, applications and useful hints for the endovascular treatment of chronic mesenteric ischemia and renal artery stenosis. This preliminary data show straightforward applicability, high technical success, and uneventful follow-up and IVL can be proposed as an useful tool for challenging revascularization of heavily calcified reno-visceral arteries.

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“…However, revascularization is a reasonable option in patients with hemodynamically significant atherosclerotic renal artery stenosis with flash pulmonary edema, recurrent unexplained congestive heart failure, progressive chronic kidney disease, and resistant hypertension[ 27 ]. Angioplasty of the renal artery could be challenging due to the large diameter, and heavily calcified plaques make it more challenging[ 28 ]. Lee et al [ 29 ] reported a heavily calcified bilateral renal artery stenosis successfully treated with IVL and stenting.…”

Section: Discussionmentioning

confidence: 99%

Use of intravascular lithotripsy in non-coronary artery lesions

Umeh,

Stratton,

Wagner

et al. 2023

World J Cardiol

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Aspirin, other antiplatelet agents, and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases. A concomitant proton pump inhibitor (PPI) treatment is often prescribed in these patients, as gastrointestinal complications are relatively frequent. On the other hand, a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs; in particular, it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel, due to pharmacodynamic and pharmacokinetic interactions through hepatic metabolism. Previously, the concomitant use of clopidogrel and omeprazole or esomeprazole has been discouraged. In contrast, it remains less known whether PPI use may affect the clinical efficacy of ticagrelor and prasugrel, new P2Y12 receptor antagonists. Current guidelines recommend PPI use in combination with antiplatelet treatment in patients with risk factors for gastrointestinal bleeding, including advanced age, concurrent use of anticoagulants, steroids, or non-steroidal anti-inflammatory drugs, and Helicobacter pylori (H. pylori ) infection. In patients taking oral anticoagulant with risk factors for gastrointestinal bleeding, PPIs could be recommended, even if their usefulness deserves further data. H. pylori infection should always be investigated and treated in patients with a history of peptic ulcer disease (with or without complication) treated with antithrombotic drugs. The present review summarizes the current knowledge regarding the widespread combined use of platelet inhibitors, anticoagulants, and PPIs, discussing consequent clinical implications.

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Use of Shockwave Intravascular Lithotripsy for the Treatment of Calcified Renal Artery Stenosis in a Symptomatic Subject

Cited by 7 publications

References 8 publications

Use of Intravascular Lithotripsy in Heavily Calcified Renal Artery Stenosis: A Case Report

Use of Intravascular Lithotripsy in Heavily Calcified Renal Artery Stenosis: A Case Report

Use of Shockwave Intravascular Lithotripsy in Recanalization of Calcified Visceral and Renal Arteries: A Case Report and Update of the Literature

Use of intravascular lithotripsy in non-coronary artery lesions

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