{"id":12658,"date":"2025-09-05T04:47:12","date_gmt":"2025-09-05T09:47:12","guid":{"rendered":"https:\/\/shockwavemedical.com\/?p=12658"},"modified":"2026-04-08T08:44:20","modified_gmt":"2026-04-08T13:44:20","slug":"shockwave-javelin-for-below-the-ankle-revascularization-in-a-patient-with-clti","status":"publish","type":"post","link":"https:\/\/shockwavemedical.com\/en-eu\/education\/shockwave-javelin-for-below-the-ankle-revascularization-in-a-patient-with-clti\/","title":{"rendered":"Shockwave Javelin for Below the Ankle Revascularization in a Patient with CLTI"},"content":{"rendered":"\n<section id=\"block_ba4f3ca476db728e76d6cf3f878449a5\" class=\"block block--wysiwyg wysiwyg_styles u-bgColorNone container\">\n\t<div class=\"u-wysiwyg u-animation\">\n\t\t<p>This case, courtesy of Dr. Ashish Patel from St Thomas\u2019, London, features a 71-year-old female patient, a smoker with hypertension Rutherford category 5 peripheral artery disease (PAD). The patient presents left hallux gangrene and severe rest pain and had no previous treatments. \u200b<\/p>\n\t<\/div>\n\t<\/section>\n\n\n<!-- BLOCK CONTENT -->\n<section id=\"block_2fb7647620c4ebe1886b2dcd6247c10d\" class=\"block block--case_module \">\n\t<div class=\"container text_colors\">\n\t\t\t<ul class=\"case_module__items\">\n\t\t\t\t\t<li class=\"media_item\" id=\"media_item-block_2fb7647620c4ebe1886b2dcd6247c10d_1\">\n\t\t\t\t\t\t\t\t\t<div class=\"item__heading h4\">Pre-procedure<\/div>\n\t\t\t\t\n\t\t\t\t<figure class=\"item__figure \">\n\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"440\" height=\"570\" data-src=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Javelin-Case-2-Images-01.png\" class=\"attachment-full size-full lazyload\" alt=\"\" data-srcset=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Javelin-Case-2-Images-01.png 440w, https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Javelin-Case-2-Images-01-232x300.png 232w\" data-sizes=\"(max-width: 440px) 100vw, 440px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 440px; --smush-placeholder-aspect-ratio: 440\/570;\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/figure>\n\n\t\t\t\t\t\t\t\t\t<div class=\"item__subheading h5\">Baseline angio shows occluded lateral plantar and dorsalis pedis arteries. \u200bAnkle-brachial index (ABI) pre-procedure: 0.4.<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t<li class=\"media_item\" id=\"media_item-block_2fb7647620c4ebe1886b2dcd6247c10d_2\">\n\t\t\t\t\t\t\t\t\t<div class=\"item__heading h4\">DCB Treatment<\/div>\n\t\t\t\t\n\t\t\t\t<figure class=\"item__figure \">\n\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"440\" height=\"570\" data-src=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Javelin-Case-2-Images-02.png\" class=\"attachment-full size-full lazyload\" alt=\"\" data-srcset=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Javelin-Case-2-Images-02.png 440w, https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Javelin-Case-2-Images-02-232x300.png 232w\" data-sizes=\"(max-width: 440px) 100vw, 440px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 440px; --smush-placeholder-aspect-ratio: 440\/570;\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/figure>\n\n\t\t\t\t\t\t\t\t\t<div class=\"item__subheading h5\">Superficial femoral artery (SFA) and popliteal artery presenting some fibrotic plaque were treated with 5.0 mm plain old balloon angioplasty (POBA) and drug-coated balloon (DCB) to improve flow.<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t<li class=\"media_item\" id=\"media_item-block_2fb7647620c4ebe1886b2dcd6247c10d_3\">\n\t\t\t\t\t\t\t\t\t<div class=\"item__heading h4\">Shockwave Javelin Treatment<\/div>\n\t\t\t\t\n\t\t\t\t<figure class=\"item__figure \">\n\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"440\" height=\"570\" data-src=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/JavelinDownPT2.gif\" class=\"attachment-full size-full lazyload\" alt=\"\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 440px; --smush-placeholder-aspect-ratio: 440\/570;\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/figure>\n\n\t\t\t\t\t\t\t\t\t<div class=\"item__subheading h5\">The lesion was wire crossable but not device crossable (IVUS did not cross).\u200b Shockwave Javelin Peripheral was able to advance through the lesion.<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t<li class=\"media_item\" id=\"media_item-block_2fb7647620c4ebe1886b2dcd6247c10d_4\">\n\t\t\t\t\t\t\t\t\t<div class=\"item__heading h4\">Shockwave Javelin Treatment<\/div>\n\t\t\t\t\n\t\t\t\t<figure class=\"item__figure \">\n\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"440\" height=\"570\" data-src=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Javelin-Treatment-2_200825-2.gif\" class=\"attachment-full size-full lazyload\" alt=\"\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 440px; --smush-placeholder-aspect-ratio: 440\/570;\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/figure>\n\n\t\t\t\t\t\t\t\t\t<div class=\"item__subheading h5\">Shockwave Javelin Peripheral was advanced via the posterior tibial artery and through the common plantar artery.<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t<li class=\"media_item\" id=\"media_item-block_2fb7647620c4ebe1886b2dcd6247c10d_5\">\n\t\t\t\t\t\t\t\t\t<div class=\"item__heading h4\">Shockwave Javelin Treatment<\/div>\n\t\t\t\t\n\t\t\t\t<figure class=\"item__figure \">\n\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"440\" height=\"570\" data-src=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/JavelinAroundFootArch3_200825-1.gif\" class=\"attachment-full size-full lazyload\" alt=\"\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 440px; --smush-placeholder-aspect-ratio: 440\/570;\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/figure>\n\n\t\t\t\t\t\t\t\t\t<div class=\"item__subheading h5\">120 pulses of Shockwave Javelin Peripheral delivered across the occluded lateral plantar and dorsalis pedis arteries.<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t\t<li class=\"media_item\" id=\"media_item-block_2fb7647620c4ebe1886b2dcd6247c10d_6\">\n\t\t\t\t\t\t\t\t\t<div class=\"item__heading h4\">Final Treatment<\/div>\n\t\t\t\t\n\t\t\t\t<figure class=\"item__figure \">\n\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" width=\"440\" height=\"570\" data-src=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Final_Angio_440x570-2.jpg\" class=\"attachment-full size-full lazyload\" alt=\"\" data-srcset=\"https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Final_Angio_440x570-2.jpg 440w, https:\/\/shockwavemedical.com\/wp-content\/uploads\/2025\/09\/Final_Angio_440x570-2-232x300.jpg 232w\" data-sizes=\"(max-width: 440px) 100vw, 440px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 440px; --smush-placeholder-aspect-ratio: 440\/570;\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/figure>\n\n\t\t\t\t\t\t\t\t\t<div class=\"item__subheading h5\">After final treatment with 2.0 mm PTA balloon, final angio shows reconstitution of flow around the foot arch.\u200b ABI post-procedure: 0.8.<\/div>\n\t\t\t\t\n\t\t\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t<\/div>\n<\/section>\n\n\n<section id=\"block_effe2af5b0db4764ba2b2a04eddf36c5\" class=\"block block--wysiwyg wysiwyg_styles u-bgColorNone container\">\n\t<div class=\"u-wysiwyg u-animation\">\n\t\t<hr \/>\n<p><span class=\"legal_copy\">Case courtesy of Dr. Ashish Patel, St Thomas\u2019, London.\u200b <\/span><\/p>\n<p><span class=\"legal_copy\">Dr. Ashish Patel is a paid consultant of Shockwave Medical.<\/span><\/p>\n<p>\u200b<\/p>\n\t<\/div>\n\t<\/section>","protected":false},"excerpt":{"rendered":"<p>This case, courtesy of Dr. Ashish Patel from St Thomas\u2019, London, features a 71-year-old female patient, a smoker with hypertension Rutherford category 5 peripheral artery disease (PAD).<\/p>\n","protected":false},"author":19,"featured_media":12659,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":[402],"meta":{"_acf_changed":false,"content-type":"","footnotes":""},"categories":[17],"tags":[],"disease-state":[151,167],"education-topic":[187],"product-tag":[420],"specialty":[332,344],"technology":[324],"class_list":["post-12658","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized-en-uk","disease-state-below-the-knee-btk","disease-state-peripheral-artery-disease-en-uk","education-topic-case-reviews-en-uk","format-case-en-uk","product-tag-shockwave-javelin-peripheral-ivl-catheter-en-uk","specialty-interventional-radiologists-en-uk","specialty-vascular-surgeons-en-uk","technology-peripheral-ivl-en-uk"],"acf":[],"_links":{"self":[{"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/posts\/12658","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/users\/19"}],"replies":[{"embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/comments?post=12658"}],"version-history":[{"count":1,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/posts\/12658\/revisions"}],"predecessor-version":[{"id":13899,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/posts\/12658\/revisions\/13899"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/media\/12659"}],"wp:attachment":[{"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/media?parent=12658"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/categories?post=12658"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/tags?post=12658"},{"taxonomy":"disease-state","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/disease-state?post=12658"},{"taxonomy":"education-topic","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/education-topic?post=12658"},{"taxonomy":"format","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/format?post=12658"},{"taxonomy":"product-tag","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/product-tag?post=12658"},{"taxonomy":"specialty","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/specialty?post=12658"},{"taxonomy":"technology","embeddable":true,"href":"https:\/\/shockwavemedical.com\/en-eu\/wp-json\/wp\/v2\/technology?post=12658"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}