Intravascular lithotripsy: a powerful tool to treat peripheral artery calcifications

Area of Science:

• Vascular Medicine
• Interventional Cardiology
• Biomedical Engineering

Background:

• Vascular calcification is a major challenge in peripheral arterial disease (PAD), predicting endovascular treatment failure.
• Calcifications impede vessel expansion, hinder drug delivery, and increase complications like dissection and embolization after percutaneous transluminal angioplasty (PTA).

Approach:

• This review synthesizes published data on the application of intravascular lithotripsy (IVL) for treating vascular calcifications.
• IVL utilizes pulsed ultrasonic waves to fracture calcified lesions, aiming to improve vessel compliance and facilitate endovascular procedures.

Key Points:

• Intravascular lithotripsy (IVL) demonstrates safety and efficacy in treating highly calcified arteries, with low complication rates.
• IVL effectively addresses vessel compliance issues and achieves luminal gain, potentially facilitating access for large-bore devices.
• Optimal sizing (1.1:1 ratio) and adjunctive therapies may be necessary to enhance long-term patency after IVL treatment.

Conclusions:

• IVL is a promising therapeutic option for patients with PAD and significant arterial calcifications.
• Further clinical studies are essential to fully elucidate the long-term benefits and optimal utilization of IVL in vascular interventions.