Crack Calcium in Large Vessels
Count On It
Faster pulsing
IVL therapy at 2 pulses per second
8.0, 9.0, 10.0 & 12.0mm diameter sizes
Compact emitter design
30mm balloon length
.018” guidewire
IVL therapy at 2-4 atm
Shockwave L6 In Real-World Applications
In Part 1, Drs. Garg, Humphries and Wooster discuss their large vessel treatment algorithms and the use of the larger Shockwave L6 sizes, while also reviewing an infrarenal EVAR case from Dr. Wooster where Shockwave L6 was used to treat a calcified CFA on the way out.
Case Courtesy of Dr. J.D. Corl │ Ohio Heart and Vascular Center, The Christ Hospital │ Cincinnati, OH
IVUS Measurements:
LCIA: 11.7 x 10.9mm
RCIA: 10.3 x 11mm
Shockwave L6 12.0mm
150 pulses each side
No vessel recoil, bifurcation preserved
Case Courtesy of Dr. Charles Briggs │ Sanger Heart and Vascular Institute – Atrium Health │ Charlotte, NC
Diameter Stenosis:
RCIA: 100% (concentric calcium)
LCIA: 80% (eccentric calcium)
Diameter Stenosis Post-IVL:
RCIA: 0%
LCIA: 15%
Fully expanded VBX stents
Diameter stenosis in both RCIA & LCIA: 0%
Case Courtesy of Dr. Peter Soukas │ The Miriam & RI Hospitals │ Providence, RI
100% stenosis
Orbital Atherectomy
US guided retrograde PFA access with .018” catheter & wire
Shockwave L6 9.0mm in CFA after PTA, IVL and DCB in PFA
No dissections or perforations
No stents placed
Case Courtesy of Dr. Frank Arko III │ Sanger Heart and Vascular Institute – Atrium Health │ Charlotte, NC
Dr. Shivani Kumar, vascular surgeon, discusses her experience treating calcified iliacs and how Shockwave IVL is uniquely positioned to treat this vessel bed. Dr. Kumar then reviews two cases where she used Shockwave L6 to treat the left common iliac artery for femoral-femoral bypass inflow and bilateral Shockwave L6 with kissing iliac stents.
| BALLOON DIAMETER (mm) |
BALLOON LENGTH (mm) |
SHEATH COMPATIBILITY (Fr) | CATHETER WORKING LENGTH (cm) | PULSES/ CYCLE | CYCLES | MAX PULSES | BALLOON CROSSING PROFILE (in) | GUIDEWIRE COMPATIBILITY (in) |
|---|---|---|---|---|---|---|---|---|
| 8.0 | 30 | 7 | 110 | 30 | 10 | 300 | 0.086 | 0.018 |
| 9.0 | 30 | 7 | 110 | 30 | 10 | 300 | 0.087 | 0.018 |
| 10.0 | 30 | 8 | 110 | 30 | 10 | 300 | 0.091 | 0.018 |
| 12.0 | 30 | 8 | 110 | 30 | 10 | 300 | 0.093 | 0.018 |
| BALLOON DIAMETER (mm) |
BALLOON LENGTH (mm) |
SHEATH COMPATIBILITY (Fr) | CATHETER WORKING LENGTH (cm) |
|---|---|---|---|
| 8.0 | 30 | 7 | 110 |
| 9.0 | 30 | 7 | 110 |
| 10.0 | 30 | 8 | 110 |
| 12.0 | 30 | 8 | 110 |
| BALLOON DIAMETER (mm) |
PULSES/ CYCLE | CYCLES | MAX PULSES | BALLOON CROSSING PROFILE (in) | GUIDEWIRE COMPATIBILITY (in) |
|---|---|---|---|---|---|
| 8.0 | 30 | 10 | 300 | 0.086 | 0.018 |
| 9.0 | 30 | 10 | 300 | 0.087 | 0.018 |
| 10.0 | 30 | 10 | 300 | 0.091 | 0.018 |
| 12.0 | 30 | 10 | 300 | 0.093 | 0.018 |
Peripheral IVL has reimbursement in the outpatient, Ambulatory Surgical Centers (ASC) and inpatient setting. Progress continues - as of October 1, 2023 Medicare reassigned peripheral IVL to newly created MS-DRG codes 278 and 279. This reassignment increased inpatient payment for IVL use both above-the-knee and below-the-knee.
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