Shockwave IVL Overview & MOA

Shockwave Intravascular Lithotripsy (IVL): Established on the Principles of Kidney Stone Treatment

Adapted for Calcium in the Cardiovascular System

For more than 30 years, urologic lithotripsy has used shock waves to break up stones in the kidney and parts of the ureter, allowing the tiny pieces of stones to pass through via urine.¹ Adapted from these principles, Shockwave IVL is an interventional procedure that utilizes a fluid-filled catheter connected to power sources that generate acoustic shock waves to modify calcified plaque in coronary and peripheral arteries.

1. The Shockwave IVL catheter is placed against a calcified blockage in the artery
2. An electrical discharge from the catheter emitters vaporizes the liquid within the balloon, creating a rapidly expanding and collapsing bubble that generates sonic pressure waves, or shock waves
3. The shock waves create a localized field effect that travels through the soft vascular tissue, selectively cracking superficial and deep calcium within the vessel wall while leaving the soft tissue undisturbed

Shock Waves Are the Basis for Lithotripsy

Shock waves are created when the source of an acoustic wave is moving faster than the speed of sound within that medium. Regardless of the energy sources, shock waves are consistent in their construction. The acoustic field of shock waves are typically measured in water using a hydrophone, which converts pressure into an electrical signal.

The key characteristics of shock waves are:

• High amplitude compression phase with very short rise time and pressure width
• Low amplitude negative pressure (tensile) phase

In Shockwave IVL, four forces of energy work in tandem to create fractures in the calcium:

1. Compression: The approaching shock wave is refracted off the calcium while the forward pressure causes fragmentation
2. Shearing: Occurs as the sound wave passes through the calcium
3. Spallation: At the rear edge of the calcium, the shock wave is both transmitted and reflected, inducing tensile stress that pulls the calcium apart
4. Squeezing: Occurs when the shock waves entering the calcium travel faster than the remaining wave propagating outside the calcium, resulting in multiplane and longitudinal fractures

Without measurable sonic output, it’s not IVL.

Shockwave IVL: The First of Its Kind

Shockwave IVL has quickly become a preferred calcium modification option for physicians worldwide because of its unique mechanism of action (MOA) and ease of use. Learn more about how Shockwave IVL was created and how its MOA cracks both superficial and deep calcium.

Simple and Intuitive IVL System

1: https://medlineplus.gov/ency/article/007113.htm