Shockwave IVL & Eccentric Calcium

Shockwave Intravascular Lithotripsy’s (IVL) sonic pressure waves provide calcium-cracking power capable of thoroughly modifying challenging calcium morphologies.

Shockwave IVL for Coronary Artery Disease Shockwave IVL & Concentric Calcium Shockwave IVL & Nodular Calcium Shockwave C2+
Digital rendering of cross-sectional view of blood vessel showing eccentric calcification

Get the Shockwave IVL Advantage When Treating Eccentric Calcium

Extending across two quadrants or less and having an arc of less than 180°, eccentric calcium can present unique treatment challenges — especially with balloon or atherectomy therapies. Shockwave IVL offers an advantage because its mechanism of action (MOA) enables it to modify superficial and deep calcium with sonic pressure waves that expand circumferentially in the arteries. Shockwave IVL’s ultra-low treatment pressure also reduces the risk of dissection where the calcium and tissue interface. 

OTHER THERAPIES: 

Illustration comparing balloon and atherectomy therapies in treating eccentric calcium in arteries.

SHOCKWAVE IVL THERAPY: 

Illustration of intravascular lithotripsy (IVL) therapy in treating calcified arteries, showing both initial and post-treatment stages.

Shockwave IVL’s Effectiveness in Eccentric Calcium

In this eccentric calcium case, we see a post-Shockwave IVL lumen area of 7.62 mm2 and a post-stent area of 8.40 mm2. 

  • Intravascular imaging showing a cross-section of an artery with eccentric calcified plaque, indicated by a labeled region on one side of the arterial wall.

    Pre IVL

    Lumen area: 4.47 mm²
  • Intravascular imaging showing a cross-section of an artery with a visible calcium fracture, highlighted and labeled on the arterial wall.

    Post IVL

    Lumen area: 7.62 mm²
  • Intravascular imaging showing a cross-section of an artery with a visible calcium fracture, highlighted and labeled on the arterial wall.

    Post Stent

    Stent area: 8.40 mm²

Shockwave IVL is Consistent in Modifying Concentric and Eccentric Calcium 

In our DISRUPT CAD clinical program, we saw similar MSA and stent expansion at max calcium site across calcium arcs. 

Two bar charts displaying minimum stent area (MSA) and stent expansion at the maximum calcium site across different continuous calcium arc degrees

 

Ali et al. Impact of Calcium Eccentricity on the Safety and Effectiveness of Coronary Intravascular Lithotripsy: Pooled Analysis From the Disrupt CAD Studies. Cir Interventions. 2023.  

Conclusions from Eccentric vs. Concentric Pooled Analysis

  • OCT demonstrated consistent MSA and stent expansion outcomes in eccentric and concentric calcium 
  • Consistent MSA and stent expansion outcomes were observed regardless of the presence of visible calcium fracture 

 

Review the full eccentric vs. concentric presentation: 

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  • Cross-sectional illustration of an artery with concentric calcified plaque buildup

    Shockwave IVL & Concentric Calcium 

    Learn how Shockwave IVL successfully modifies concentric calcium. 

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  • Cross-sectional illustration of an artery with nodular calcified plaque buildup

    Shockwave IVL & Nodular Calcium

    Learn how Shockwave IVL successfully modifies nodular calcium. 

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