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Crack the Complexities of BTK Calcium

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Anterior Tibial Artery and TP Trunk Disease

This was an 86 year-old female Rutherford 5 CLI patient with extensive btk disease. The patient’s medical history includes: CAD, DM-2, HTN, HLD, ESRD on HD, former smoker and Diastolic CHF. With a high take-off of anterior tibial IVUS showed reference vessel diameter of 3.5mm with extensive calcification. A 4.0mm Shockwave M5+ catheter was used to treat the AT and TPT for an excellent angiographic result. The follow-up duplex scan showed patency in both the AT and TPT with wound healing at about 4-5 weeks.

Pre-Treatment Angiogram

Pre-Treatment Angiogram
AT diameter stenosis = 99% TPT diameter stenosis = 90%

IVL Treatment TPT

ivl treatment xray progression
4 x 60mm Shockwave M5+ 150 pulses

IVL Treatment AT

IVL Treatment AT xray progression
4 x 60mm Shockwave M5+ 150 pulses

Post-IVL Angiogram

Post IVL Angiogram xray progression
AT diameter stenosis = 0% TPT stenosis = 0%
Case courtesy of Dr. JD Corl

LARGEST REAL-WORLD EXPERIENCE WITH SHOCKWAVE IVL IN CLI PATIENTS1

PAD III OS Sub-Analysis of 1,373 Patients
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450
Patients with CLI
 
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543
Lesions
 
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87%
Lesions Moderate-Severe Calcification
 
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41%
Patients on Dialysis
 
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35%
Lesions were CTO
 
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30%
Single-Vessel or Absent Runoff
 

IVL PROVEN SAFE AND EFFECTIVE IN CLI PATIENTS

Angiographic Outcomes

Core Lab Adjudicated

Angiographic Outcomes table

DIAMETER STENOSIS

Angiographic Outcomes graph
Consistent Outcomes in Complex CLI Subgroups
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Watch Dr. Soukas’s interview and case examples

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PROSPECTIVE, GLOBAL STUDY
INCLUDING CLI PATIENTS
WITH LONG, CALCIFIED BTK LESIONS
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IVL for BTK Calcium

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Dr. Armstrong CLI Case: Nonhealing Wound to Right Great Toe & Non-compressible ABI
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Dr. Armstrong CLI Case: PMH of Diabetes & CKD – Nonhealing Wound of Plantar Surface of 4th Digit
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Dr. Armstrong CLI Case: Complex Intervention – Nonhealing Left 2nd, 3rd, & 4th Digits
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Dr. Armstrong CLI Case: Inframalleolar Disease with Occlusion of Plantar Artery
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Shockwave IVL for CLTI Patients by Dr. Thulasidasan
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CLI Case Review with
Dr. J.D. Corl
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RESOURCES

sw s4 tech sheet
Shockwave S4 Tech Sheet
Shockwave S4 Tech Sheet
Download
sw m5p tech sheet
Shockwave M5+ Tech Sheet
Shockwave M5+ Tech Sheet
Download
Feasibility of Intravascular Lithotripsy journal
Safety & Feasibility of IVL
Safety and Feasibility of Intravascular Lithotripsy for Treatment of Below-the-Knee Arterial Stenoses, Brodmann et al, JEVT, August 2018
Read More
Safe Effective Treatment of Below the Knee Calcium in CLI Patients pdf
Safe & Effective Treatment of BTK
Safe and Effective Treatment of Below-the-Knee Calcium in CLI Patients, by Dr. Sameh Sayfo
Read More
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IVL for Critical Limb Ischemia
Intravascular Lithotripsy for Critical Limb Ischemia by Dr. Michael Meuse and Dr. Raj Pyne
Download
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BTK Sponsored Podcast
Treating Below the Knee Calcium with Dr. Kumar Madassery & Dr. Sabeen Dhand
Listen to Podcast
s4 2

See how Shockwave S4 was designed for below‑the‑knee calcium modification

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Shockwave C2 IVL catheter
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On The +Plus Side

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

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