Intravascular Lithotripsy for Treatment of Calcified, Stenotic Iliac Arteries: A Cohort Analysis From the Disrupt PAD

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Ehrin J Armstrong1, Peter A Soukas2, Nicolas Shammas3

  • 1University of Colorado School of Medicine, Aurora, CO, United States of America.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|March 10, 2020
PubMed

Insights

Peripheral intravascular lithotripsy (IVL) effectively treats calcified iliac artery disease, showing promising safety and efficacy. This approach is suitable for both peripheral artery disease symptoms and improving large-bore access.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Iliac artery calcification complicates endovascular interventions, increasing risks and reducing success rates.
  • Peripheral artery disease (PAD) management often involves treating calcified lesions, posing significant challenges for traditional methods.

Purpose of the Study:

  • To evaluate the safety and efficacy of peripheral intravascular lithotripsy (IVL) for treating calcified iliac artery lesions in patients with PAD.
  • To assess the 'real-world' performance of the Shockwave Peripheral IVL System in a diverse patient cohort.

Main Methods:

  • Prospective, multi-center, single-arm study (Disrupt PAD III Observational Study) analyzing 118 patients with calcified iliac lesions.
  • IVL catheter delivery was assessed for successful treatment of de novo calcified lesions, with a focus on lesion characteristics and procedural outcomes.
  • Data collected included lesion length, stenosis severity, calcification extent, and need for adjunctive therapies like stenting.

Main Results:

  • Successful IVL catheter delivery was achieved in all 118 patients, treating 200 lesions.
  • Severe calcification was present in 82% of cases, with a mean residual stenosis of 12.0% post-procedure.
  • Minimal angiographic complications were observed, with no flow-limiting dissections, indicating a favorable safety profile.

Conclusions:

  • Peripheral IVL demonstrates safety and efficacy as a treatment option for calcified, stenotic iliac lesions.
  • IVL is a viable tool for managing PAD symptoms and optimizing iliac vasculature for large-bore access procedures.
Abstract

Keywords:
CalcificationIliac arteryLithoplastyLithotripsyPeripheral artery disease

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