Shockwave IVL Below the Knee

Raise your expectations for below-the-knee (BTK) outcomes. Shockwave Intravascular Lithotripsy (IVL) cracks the complexity of BTK calcium with safe, effective treatment that extends to remarkable lengths.

digital rendering of shockwave E8 device
digital rendering of shockwave E8 device

Take Below-the-Knee (BTK) Treatment Above and Beyond

The challenges of BTK are made worse by stubborn calcium, with therapies challenged by dissections,1 poor vessel expansion2 and acute recoil.3 With Shockwave IVL, you can safely modify both superficial and deep calcium at ultra-low pressures that won’t impact soft tissue4 — plus our mechanism of action (MOA) is specifically built to treat BTK arteries. 

  

1 Fitzgerald et al, Contribution of localized calcium deposits to dissection after angioplasty. An observational study using intravascular ultrasound, Circulation 1992.
2 Rocha-Singh et al, Peripheral arterial calcification: prevalence, mechanism, detection, and clinical implications, Catheter Cardiovasc Interv, 2014.
3 Baumann et al, Early recoil after balloon angioplasty of tibial artery obstructions in patients with critical limb ischemia, J Endovasc Ther 2014.
4 Kereiakes, DJ, Virmani, R, Hokama JY, et. al. Principles of intravascular lithotripsy for calcific plaque modification. J Am Coll Cardiol Intv 2021. 

Shockwave IVL Proven Safe and Effective in Patients with CLTI 

Accordion Section

Largest Real-World Experience with Shockwave IVL in Chronic Limb-Threatening Ischemia (CLTI) Patients1

DISRUPT PAD III Observational Study Sub-Analysis of 1,373 patients 

Statistics Callout

This section presents key statistical information with numbers and descriptions.

  • 450
    Patients with CLTI
  • 543
    Lesions
  • 87
    %
    Lesions moderate-severe calcification
  • 41
    %
    Patients on dialysis 
  • 35
    %
    Lesions were chronic total occlusion (CTO)
  • 30
    %
    Single-vessel or absent runoff

1: Intravascular Lithotripsy for the Treatment of Patients with Critical Limb Ischemia, Peter A. Soukas, MD. Presented at The Amputation Prevention (AMP) Symposium. Chicago, IL. USA, August 2022.

Featured BTK Case: Anterior Tibial Artery (ATA) and Tibioperoneal Trunk (TPT) Disease

An 86-year-old female Rutherford 5 CLTI patient with extensive BTK disease had a medical history that included coronary artery disease (CAD), diabetes mellitus-2, hypertension, hyperlipidemia, end stage renal disease on hemodialysis (HD), former smoker and diastolic congestive heart failure. With a high take-off of the anterior tibial, IVUS showed a reference vessel diameter of 3.5 mm with extensive calcification. A Shockwave M5+ 4.0 mm catheter was used to treat the ATA 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. Case courtesy of Dr. JD Corl.

Series of four angiogram images demonstrating below-the-knee treatment using intravascular lithotripsy (IVL)

Go Deeper: Presentations and Case Studies

  • image of presentation with headshot of a professional presenting on consistent outcomes in complex CLI subgroups.
  • image of presentation with headshot of a professional presenting on consistent outcomes in complex CLI subgroups.
  • image of presentation with