Pre-TAVR/TAVI IVL in Calcified Iliacs

85 year old woman with critical aortic stenosis and severe rest pain. Not a surgical candidate due to lung disease. Calcified near-occlusion of distal aorta and no transcaval or subclavian access option available. 7.0mm x 60mm Shockwave IVL delivered to bilateral iliac arteries. Post-IVL safe passage of a 26mm Medtronic Evolut R TAVR/TAVI device followed by endovascular femoral repair. Patient discharged the following day.