Case courtesy of Dr. Michael Siah

79M patient with CLTI and non-healing wound on his right second toe. His comorbidities include CAD, AF, DVT, CHF (EF 30%), and DM2. He previously had a CABG, and right popliteal angioplasty (2022). The patient underwent a second toe amputation prior to this revascularization. The patient was non-compressible and had an initial toe pressure of 15. The initial angiogram showed long segment AT disease and slow flow in the PT. Dr. Siah treated the AT with a Shockwave E8 4.0 mm, using 200 pulses over three treatment areas. The catheter was easily delivered and no pre-diliation was required. IVL was used as a stand-alone treatment in the AT and brisk flow was achieved with no complications. He then treated the focal PT stenosis with a 3.0 mm POBA. Post-procedure the patient's toe pressure was 85. At two-month follow-up the patient's wound has healed significantly and the AT remained open providing brisk flow to the foot. Shockwave E8 allowed for safe and effective treatment of long-segment AT disease in this patient with CLTI, ultimately supporting wound healing for this patient.

Case courtesy of Dr. Mazin Foteh

69M with HTN, CAD, DM with CLTI and non-healing wound on his right heel. Patient had PAD in all three vessels but the Posterior Tibial was targeted for treatment for wound healing. PT was 100% occlusive throughout various segments of vessel. The patient was non-compressible and had an initial toe pressure of 57. Dr. Foteh used Shockwave E8 as standalone therapy to treat. He used 2.5 mm Shockwave E8  for distal PT and 3.5 mm Shockwave E8 for proximal PT. Post-procedure, the patient had toe pressure of 87 with no complications.

"Shockwave E8 delivered tremendously. I am surprised how well it tracked without pre-dil and I love the length and efficient energy through entire balloon." - Dr. Foteh