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Best Practice in Intravascular Lithotripsy.

Benjamin Honton1, Jacques Monsegu2

  • 1Department of Interventional Cardiology, Clinique Pasteur Toulouse, France.

Interventional Cardiology (London, England)
|February 14, 2022
PubMed
Summary

Intravascular lithotripsy (IVL) effectively treats calcified plaques in arteries. This novel approach uses sonic pressure waves to increase vessel compliance before stenting, demonstrating high efficacy and safety.

Keywords:
Disrupt CADIntravascular lithotripsybest practicecoronary calcified lesionplaque modification

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Severely calcified plaques in coronary and peripheral vessels pose a challenge for stent implantation.
  • Intravascular lithotripsy (IVL) is an emerging technology for lesion preparation in such cases.
  • IVL utilizes sonic pressure waves generated by fluid vaporization to fracture arterial calcifications.

Purpose of the Study:

  • To review the best practices for utilizing Intravascular Lithotripsy (IVL) in the cardiac catheterization laboratory.
  • To synthesize current scientific data and clinical experience with IVL technology.
  • To guide interventional cardiologists in applying IVL to complex calcified lesions.

Main Methods:

  • Review of clinical data from the Disrupt CAD trials.
  • Analysis of 3 years of operator experience with IVL.
  • Focus on practical application and best practices in the cath lab setting.

Main Results:

  • IVL demonstrates high efficacy in preparing severely calcified lesions.
  • The procedure leads to increased vessel compliance, facilitating successful stent implantation.
  • IVL exhibits an excellent safety profile in clinical use.

Conclusions:

  • Intravascular lithotripsy is a valuable tool for lesion preparation in complex calcified arterial disease.
  • The technology has expanded to more challenging clinical scenarios since its CE mark approval in 2017.
  • Continued experience and data support the optimal use of IVL in interventional cardiology.