Sound Principles

Prof. Holger Nef

Giessen University Hospital, Giessen, Germany

Associate Director

Intravascular lithotripsy: Not an eccentric option for eccentric calcium
“IVL catheters are equipped with lithotripsy emitters that deliver localised pulsatile acoustic pressure waves circumferentially to modify vascular calcium. This provides the unique opportunity to modify the calcified plaque homogenously and reach calcification even in deeper vessel layers. Since the IVL works as a rapid exchange system—like a normal angioplasty balloon catheter—the ease of use is obvious.”
(Source: Cardiovascular News, 26 May 2021)

Dean Kereiakes MD, FACC, FSCAI

Medical Director of The Christ Hospital Heart and Vascular Center & The Christ Hospital
Research Institute. Professor of Clinical Medicine, The Ohio State University

Intravascular lithotripsy beneficial for calcified lesions in various vascular beds.
“IVL represents a quantum step forward in our ability to safely treat patients with severely calcified arteries.”
(Source: Cardiology Today, 7 July 2021)

Prof. Andrew Holden

Associate Professor Andrew Holden MBChB, FRANZCR, EBIR, ONZM
Auckland City Hospital & Director of Northern Region Interventional Radiology Service

The emerging value and broad applicability of intravascular lithotripsy.
“The phenomenon of low-pressure dilatation of calcified vessels is a frequent and impressive finding after IVL. Confirmation of this controlled fracturing of vascular calcification has been obtained in preclinical cadaveric micro-CT studies. Clinically, this has also been demonstrated on intravascular ultrasound (IVUS) and optical coherence tomography (OCT).”
(Source: Vascular News 30 July 2020)

Dean Kereiakes MD, FACC, FSCAI

Medical Director of The Christ Hospital Heart and Vascular Center & The Christ Hospital
Research Institute. Professor of Clinical Medicine, The Ohio State University

Dean Kereiakes on CAD III RCT.
“The correlation between calcium severity and poor percutaneous coronary intervention outcomes is well established and is a challenge we face on a daily basis in the cath lab. Given the severity of lesion and vessel calcium that was present in CAD III, it makes the findings of the study even more significant and noteworthy. The high rate of procedural success, combined with the low rate of major adverse cardiovascular events in CAD III, not only met the performance goals, but it also surpassed our expectations as investigators.”
(Source: Shockwave Medical News Release 16 Feb 2021)

William A. Gray, MD

Chief of Cardiovascular Services, Main Line Health, Wynnewood, PA
President, Lankenau Heart Institute, Wynnewood, PA

Bill Gray on PAD III RCT.
“Until the Shockwave PAD III trial, there have been few data available to provide treatment guidance for this challenging population, as patients with severe calcification have historically been excluded from endovascular treatment trials,” Said Dr. Gray, who presented the PAD III results. “IVL superiority over PTA in acute procedural success establishes the new standard in safety and effectiveness, and we now have Level I evidence to help inform our lesion preparation strategy.”
(Source: Shockwave Medical News Release 7 Nov 2021)

Dr. Ziad A. Ali, MD, MRCS, MRCP, DPhil

St. Francis Hospital & Heart Center, NY

“IVL is safe on soft tissue because these acoustic pulses are soft on soft and hard on hard. The impedance of water and soft tissue are actually very close but the impedance of bone or calcium are magnitudes different which allows these differential affects to occur. As a result, IVL has the ability to modify superficial and deep calcium vessel wall calcium without the need for high pressure inflations”
(Source: How IVL is Adapted for the Vascular Space by Dr. Ziad Ali, Masterclass video)