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      Best Practice in Intravascular Lithotripsy

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          Abstract

          Intravascular lithotripsy (IVL) is a novel approach to lesion preparation of severely calcified plaques in coronary and peripheral vessels. Lithotripsy is delivered by vaporising fluid to create an expanding bubble that generates sonic pressure waves that interact with arterial calcification. Available data indicate that IVL leads to increased vessel compliance before stent implantation with high efficacy and an excellent safety profile. Since it gained the CE mark in 2017, and with improved operator experience, the use of IVL has expanded into more complex clinical situations. This review focuses on the best practice for IVL use in the cath lab, based on 3 years of experience with the technology and the latest scientific data from the Disrupt CAD clinical trials.

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          Most cited references30

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          High-speed rotational atherectomy before paclitaxel-eluting stent implantation in complex calcified coronary lesions: the randomized ROTAXUS (Rotational Atherectomy Prior to Taxus Stent Treatment for Complex Native Coronary Artery Disease) trial.

          This study sought to determine the effect of rotational atherectomy (RA) on drug-eluting stent (DES) effectiveness.
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            Ischemic outcomes after coronary intervention of calcified vessels in acute coronary syndromes. Pooled analysis from the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) and ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) TRIALS.

            This study sought to determine the frequency and impact of coronary calcification among patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS).
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              Intravascular Lithotripsy for Treatment of Severely Calcified Coronary Artery Disease: The Disrupt CAD III Study

              Coronary calcification hinders stent delivery and expansion and is associated with adverse outcomes. Intravascular lithotripsy (IVL) delivers acoustic pressure waves to modify calcium, enhancing vessel compliance and optimizing stent deployment.
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                Author and article information

                Journal
                Interv Cardiol
                Interv Cardiol
                ICR
                Interventional Cardiology: Reviews, Research, Resources
                Radcliffe Cardiology
                1756-1477
                1756-1485
                28 January 2022
                January 2022
                : 17
                : e02
                Affiliations
                [1. ] Department of Interventional Cardiology, Clinique Pasteur Toulouse, France
                [2. ] Department of Interventional Cardiology, Institut Cardio-Vasculaire, Groupe Hospitalier Mutualiste Grenoble, France
                Author notes

                Disclosure: BH receives speaker fees from Shockwave. JM has no conflicts of interest to declare.

                Correspondence: Benjamin Honton, Clinique Pasteur, 45 avenue de Lombez, BP 27617, 31076 Toulouse, France. E: bhonton@ 123456clinique-pasteur.com

                Support: The publication of this article was supported by Shockwave Medical Inc.

                Article
                10.15420/icr.2021.14
                8826142
                35154381
                48e6df1d-482f-4079-9e0e-ef0aaccc0860
                Copyright © 2022, Radcliffe Cardiology

                This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.

                History
                : 14 May 2021
                : 23 September 2021
                Page count
                Pages: 6
                Categories
                Coronary

                intravascular lithotripsy,coronary calcified lesion,best practice,plaque modification,disrupt cad

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