IVL opens calcified iliacs to enable passage of TAVi device

This patient was an 85-year-old woman with critical aortic stenosis and severe rest pain. This patient was not a surgical candidate due to lung disease. She had a calcified near-occlusion of distal aorta and no transcaval or subclavian access option available. Shockwave M5 was delivered to both iliacs and IVL therapy was used, allowing the safe passage of a 26mm Metronic Evolut R TAVI device, followed by endovascular femoral repair. The patient was discharged the next day.


tvar pre procedure 1

Bilateral IVL

bilateral xray progression


pre tavr xray progression
Case courtesy of Dr. Brian Kolski

IVL-assisted TF TAVI Proved to be Safe and Effective

European Registry: IVL to Facilitate Transfemoral TAVI


To report on the safety and efficacy of IVL-assisted TF TAVI in an all-comers population

  • Prospective, real-world, multi-center registry
  • All patients treated by IVL-assisted TF TAVI ’18 - ’20
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High-volume European centers
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4.6 ± 0.9mm w/ 318° of calcium

Results: High Success, Low Complications

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IVL has helped to expand the indications for TF TAVI in patients with severe calcific PAD

Transfemoral TAVI (%)

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IVL-Assisted TAVI (%)

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Nardi & De Backer et al. Peripheral intravascular lithotripsy of iliofemoral arteries to facilitate transfemoral TAVI: a multicentre prospective registry. EuroIntervention 2021;17-online publish-ahead-of-print November 2021.


A Prospective Registry of Intravascular Lithotripsy-Enabled Vascular Access for Transfemoral Transcatheter Aortic Valve Replacement, Di Mario et al, JACC Interventions, March 2019.
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intravascular lith pdf
Intravascular Lithotripsy-Assisted Transfemoral TAVI: The Copenhagen Experience and Literature Review, De Backer et al, Frontiers in Cardiovascular Medicine, September 2021.
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Peripheral intravascular lithotripsy pdf
Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study, Nardi et al, Eurointervention, April 2022.
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On The +Plus Side

See how the faster, further, larger Shockwave M5+ can help treat your patients with calcified PAD

Shockwave M5+ IVL catheter

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