Interventional procedure overview of intravascular lithotripsy to treat calcified coronary arteries during percutaneous coronary intervention
Closed for comments This consultation ended on at Request commenting lead permission
What the procedure involves
In this procedure, intravascular lithotripsy is administered to the calcified coronary artery before stent placement during PCI.
A percutaneous guidewire is passed through a catheter inserted from the radial or femoral artery into the coronary artery. Then, an IVL catheter with embedded emitters enclosed in an integrated angioplasty balloon is passed and connected to an external generator with a cable. The catheter is advanced to the target lesion guided by X-ray imaging of radio-opaque markers on the catheter. The balloon is then inflated with a saline and contrast solution to ensure contact with the vessel wall. The lithotripsy cycle is then started. For every cycle, the catheter emits localised, high-energy, pulsatile, unfocused, circumferential, sonic, pressure waves (lasting microseconds). These waves pass through the inflated balloon into the wall of the coronary artery. As the waves travel along the wall and the connective tissue, they disrupt calcium deposits (both intimal and medial calcium) by micro-fracturing the calcified lesions. The balloon is then deflated to allow blood supply to return to the heart.
The cycle can be repeated until the lesion has expanded enough to allow optimal stent placement or the total pulses available are used.
How are you taking part in this consultation?
You will not be able to change how you comment later.
You must be signed in to answer questions