Intravascular Lithotripsy Facilitated Percutaneous Endovascular Intervention of the Aortic Arch: A Single-Center Experience.
Aged
Aged, 80 and over
Aorta, Thoracic
/ diagnostic imaging
Brachiocephalic Trunk
/ diagnostic imaging
Carotid Stenosis
/ diagnostic imaging
Endovascular Procedures
/ adverse effects
Humans
Lithotripsy
/ adverse effects
Male
Middle Aged
Retrospective Studies
Severity of Illness Index
Subclavian Artery
/ diagnostic imaging
Treatment Outcome
Vascular Calcification
/ diagnostic imaging
Calcified lesions
Carotid stenting
Intravascular lithotripsy
Peripheral interventions
Journal
Cardiovascular revascularization medicine : including molecular interventions
ISSN: 1878-0938
Titre abrégé: Cardiovasc Revasc Med
Pays: United States
ID NLM: 101238551
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
24
04
2020
accepted:
24
04
2020
pubmed:
11
5
2020
medline:
20
1
2021
entrez:
11
5
2020
Statut:
ppublish
Résumé
Intravascular lithotripsy (IVL) (Shockwave Medical, Inc., Fremont, California, USA) is a novel technology used to modify heavily calcified atherosclerotic plaque in vessels to help facilitate percutaneous coronary intervention and has been shown to be effective in treating critical lesions within the lower limbs. In addition, studies are currently underway evaluating IVL's feasibility in de novo calcified stenotic coronary arteries before stenting. The use and associated complications of IVL in other vascular territories are underreported. We report our institution's initial experience using IVL for the treatment of complex, heavily calcified lesions within the aortic arch vessels. We treated five patients with IVL of the aortic arch vessels, including the carotid (2), subclavian (2), and innominate arteries. Four of the five patients underwent successful IVL treatment and intervention without complications. One patient (carotid intervention) developed acute right eye blindness post-procedure, thought to be due to an embolic plaque, which was successfully treated with tissue plasminogen activator and intravenous heparin. IVL offers promising technology to facilitate the treatment of complex lesions in the vessels of the aortic arch. We do not promote the use of IVL but promote prospective clinical trials to assess the safety and efficacy of this technology in this vascular territory.
Sections du résumé
BACKGROUND
Intravascular lithotripsy (IVL) (Shockwave Medical, Inc., Fremont, California, USA) is a novel technology used to modify heavily calcified atherosclerotic plaque in vessels to help facilitate percutaneous coronary intervention and has been shown to be effective in treating critical lesions within the lower limbs. In addition, studies are currently underway evaluating IVL's feasibility in de novo calcified stenotic coronary arteries before stenting. The use and associated complications of IVL in other vascular territories are underreported. We report our institution's initial experience using IVL for the treatment of complex, heavily calcified lesions within the aortic arch vessels.
METHODS AND RESULTS
We treated five patients with IVL of the aortic arch vessels, including the carotid (2), subclavian (2), and innominate arteries. Four of the five patients underwent successful IVL treatment and intervention without complications. One patient (carotid intervention) developed acute right eye blindness post-procedure, thought to be due to an embolic plaque, which was successfully treated with tissue plasminogen activator and intravenous heparin.
CONCLUSION
IVL offers promising technology to facilitate the treatment of complex lesions in the vessels of the aortic arch. We do not promote the use of IVL but promote prospective clinical trials to assess the safety and efficacy of this technology in this vascular territory.
Identifiants
pubmed: 32386683
pii: S1553-8389(20)30235-9
doi: 10.1016/j.carrev.2020.04.029
pii:
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1006-1015Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest Ron Waksman – Advisory Board: Amgen, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.; Consultant: Amgen, Biotronik, Boston Scientific, Cardioset, Cardiovascular Systems Inc., Medtronic, Philips, Pi-Cardia Ltd.; Grant Support: AstraZeneca, Biotronik, Boston Scientific, Chiesi; Speakers Bureau: AstraZeneca, Chiesi; Investor: MedAlliance. All other authors have no conflicts of interest to disclose.