In this three-episode tutorial series, Dr. Stefano Fazzini and Dr. Michel Bosiers provide an excellent overview on how IVL removes the barriers of calcified hostile access and expands treatment boundaries in EVAR and TEVAR procedures by changing vessel compliance, facilitating luminal gain and significantly reducing complications.
Calcified Bilateral Iliacs: Changing Compliance for Large Bore Access
A 78-year-old female patient was referred for evaluation of AAA associated with PAD. A pre-procedural CT showed heavily calcified iliacs. Shockwave L6 9.0mm was used in both iliacs to modify calcium. IVL changed vessel compliance for successful graft delivery and good stent-to-vessel wall apposition.
Pre-Procedural CT
Heavily calcified iliacs
RVD: 8.5mm for both iliacs
RVD: 8.5mm for both iliacs
IVL Therapy Angio - Right Common
Shockwave L6 9.0mm, 150 pulses
IVL Therapy Angio - Left Common
Shockwave L6 9.0mm, 150 pulses
Final Angiogram
>20% residual stenosis, no dissections, no embolization
Successful Graft Placement
