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.
In Part 2, the physicians expand their conversation to the entire Shockwave IVL peripheral portfolio and review a case from Dr. Humphries where Shockwave L6 was used to effectively modify a calcific iliac artery in order to place a sheath for a successful physician-modified endograft delivery.
Case Courtesy of Dr. J.D. Corl │ Ohio Heart and Vascular Center, The Christ Hospital │ Cincinnati, OH
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
RCIA: 100% (concentric calcium)
LCIA: 80% (eccentric calcium)
Diameter Stenosis Post-IVL:
Fully expanded VBX stents
Diameter stenosis in both RCIA & LCIA: 0%
Case Courtesy of Dr. Peter Soukas │ The Miriam & RI Hospitals │ Providence, RI
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
|SHEATH COMPATIBILITY (Fr)||CATHETER WORKING LENGTH (cm)||PULSES/ CYCLE||CYCLES||MAX PULSES||BALLOON CROSSING PROFILE (in)||GUIDEWIRE COMPATIBILITY (in)|
|SHEATH COMPATIBILITY (Fr)||CATHETER WORKING LENGTH (cm)|
|PULSES/ CYCLE||CYCLES||MAX PULSES||BALLOON CROSSING PROFILE (in)||GUIDEWIRE COMPATIBILITY (in)|
Peripheral IVL has reimbursement in the outpatient, Ambulatory Surgical Centers (ASC) and inpatient setting. The beginning of 2023 brings further progress with the Medicare payment increases for IVL in the treatment of iliac, femoral and popliteal arteries in the ASC setting.
But, right now we're in the early phases of the R&D program. In the meantime, don't miss the IVL application that heart teams are embracing already — maintaining transfemoral TAVR access through heavily calcified iliacs by using IVL.