Calcific Plaque Modification by Acoustic Shockwaves: Intravascular Lithotripsy in Cardiovascular Interventions

Purpose of Review To provide a review of recent literature on the treatment of moderate-to-severe calcification in coronary and peripheral vasculature with intravascular lithotripsy (Shockwave Medical, Santa Clara, CA). Recent Findings Moderate-to-severe calcific plaques constitute a significant pro...

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Bibliographic Details
Published in:Current cardiology reports 2022-05, Vol.24 (5), p.519-528
Main Authors: Ozdemir, Denizhan, Karimi Galougahi, Keyvan, Petrossian, Gregory, Ezratty, Charlotte, Dominguez-Sulca, Dylan, Chowdhury, Elma, Scheiner, Jonathan, Thomas, Susan V, Shlofmitz, Richard A., Ali, Ziad A.
Format: Article
Language:English
Subjects:
Acoustics
Cardiology
Humans
Lithotripsy - adverse effects
Medicine
Medicine & Public Health
New Therapies for Cardiovascular Disease (AA Bavry and MR Massoomi
Section Editors
Stents
Topical Collection on New Therapies for Cardiovascular Disease
Treatment Outcome
Vascular Calcification - diagnostic imaging
Vascular Calcification - etiology
Vascular Calcification - therapy
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Summary:Purpose of Review To provide a review of recent literature on the treatment of moderate-to-severe calcification in coronary and peripheral vasculature with intravascular lithotripsy (Shockwave Medical, Santa Clara, CA). Recent Findings Moderate-to-severe calcific plaques constitute a significant proportion of lesions treated with transcatheter interventions in the coronary and peripheral vascular beds and portend lower procedural success rates, increased periprocedural major adverse events, and unfavorable long-term clinical outcomes compared to non-calcific plaques. Intravascular lithotripsy (IVL) is a new technique that uses acoustic shock waves in a balloon-based system to induce fracture in the calcium deposits to facilitate luminal gain and stent expansion. Summary IVL demonstrated high procedural success and low complication rates in the management of moderate-to-severe calcification in coronary and peripheral vascular beds and led to large luminal gain by modification of calcific plaque as assessed by optical coherence tomography. Further studies will determine the role of IVL in an integrated, protocolized approach to the treatment of severely calcified plaques in the coronary and peripheral vascular beds.
ISSN:1523-3782
1534-3170
DOI:10.1007/s11886-022-01674-9