Year: 2024
Type: article
Study design: Observational Study
Abstract: Objectives: Presence of calcification is a significant risk factor for treatment resistance during endovascular therapy, limiting vessel expansion and increasing rates of complication. The goal of this study is to assess the safety and efficacy of intravascular lithotripsy (IVL) in the treatment of calcified peripheral arterial lesions in patients with claudication. Materials and Methods: Patients within our institution treated with IVL in lower extremity calcified lesions from 2018 to 2022 were identified. Our study population was limited to patients classified as Rutherford 1 to 3. The following data points were obtained: pre-/post-IVL luminal stenosis (measured by digital subtraction angiography), pre-/post-IVL ankle-brachial index (ABI), lesion location, adjunctive therapies used at the target lesion, and intraprocedural complications. Overall, 22 target lesions in 18 patients were identified. Pre- and post-treatment ABI measurements were available in 14 treated lower extremities. Results: Mean luminal gain in all target lesions treated with IVL was 81.3%. Analysis of vessel location subgroups demonstrated a luminal gain of 80.6% in the aortoiliac segment (n = 8), 76.7% in the common femoral artery (n = 3), and 83.1% in the femoropopliteal segment (n = 11). Luminal gain in lesions treated with IVL alone and IVL with adjunctive therapies was 75.4% and 85.38%, respectively. A mean improvement in ABI of 0.20 (P<.0001) was observed across 14 treated limbs. Intraprocedural complications occurred in 1 out of 22 target lesions, which was 1 case of distal embolization successfully managed with aspiration thrombectomy. Conclusion: Treatment with IVL may facilitate safe and effective luminal gain and vessel preparation in patients with claudication.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7123874774