Intravascular Lithotripsy For Severe Peripheral Artery Calcification - A 3-Year Single Centre Experience
Inês Gueifão1, Ricardo Correia1, Anita Quintas1
1Hospital de Santa Marta, Unidade Local de Saúde de São José, Lisbon, Portugal; NOVA Medical School, Lisbon, Portugal.
Portuguese Journal of Cardiac Thoracic and Vascular Surgery
|November 13, 2025
Summary
Intravascular lithotripsy (IVL) effectively prepares severely calcified arteries for endovascular procedures in peripheral artery disease (PAD). This adjunctive treatment demonstrated safety and efficacy, with low complication rates in femoropopliteal interventions.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Severe arterial calcification poses significant challenges in endovascular procedures, impacting success rates and patient outcomes.
- Conventional balloon angioplasty often yields insufficient luminal gain, necessitating advanced plaque modification techniques.
- Intravascular lithotripsy (IVL) has emerged as a promising adjunctive strategy for treating complex arterial lesions.
Purpose of the Study:
- To evaluate the institutional experience and outcomes of using intravascular lithotripsy (IVL) for peripheral artery disease (PAD) treatment.
- To assess the safety and efficacy of IVL as a vessel preparation tool in endovascular revascularization.
- To analyze procedural success, complications, and clinical outcomes in patients undergoing IVL for PAD.
Main Methods:
- Retrospective analysis of a prospectively maintained database from October 2021 to September 2024.
- Inclusion of patients who underwent IVL for vessel preparation during endovascular treatment of PAD.
- Data collection included patient demographics, risk factors, lesion characteristics, procedural details, and clinical outcomes.
Main Results:
- Nineteen patients (79% male, median age 76) with PAD were treated, primarily with femoropopliteal lesions (68%).
- IVL facilitated lesion crossing and was predominantly followed by stenting (79%), with no procedural complications reported.
- Major adverse limb events (MALE) were low (5% major amputation), and all-cause mortality was 16%.
Conclusions:
- Intravascular lithotripsy (IVL) is a safe and effective adjunctive therapy for vessel preparation in endovascular revascularization, particularly for femoropopliteal lesions.
- The procedure demonstrated infrequent complications, MALE, and mortality.
- Further research is warranted for aortoiliac and infrapopliteal applications and comparative studies with alternative treatments.
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