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Int J Angiol 2023; 32(01): 011-020
DOI: 10.1055/s-0042-1751229
Original Article

Intravascular Lithotripsy in Calcified Peripheral Lesions: Single-Center JEN-Experience

Pawel Aftanski  ‡   *
1   Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany
,
Marcus Thieme‡   *
1   Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany
2   Department of Angiology, Cardiology, Diabetology, Regiomed-Vascular Center, Sonneberg, Germany
,
Friederike Klein
1   Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany
,
P. Christian Schulze
1   Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany
,
Sven Möbius-Winkler‡   *
1   Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany
,
Daniel Kretzschmar‡   *
1   Department of Internal Medicine I, Jena University Hospital, Friedrich-Schiller University Jena, Jena, Germany
› Author Affiliations Funding None.
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Abstract

Peripheral artery disease (PAD) shows increasing need for revascularization therapy. Interventional success in calcified lesions is limited. Here, intravascular lithotripsy (IVL), modifying intimal and medial calcium, is a promising treatment approach. A single-center, prospective all-comers registry for patients undergoing peripheral IVL was established to examine treatment success in PAD with severe vessel calcification. Periprocedural safety events as well as short-term and intermediate follow-up clinical data were evaluated. Between December 2018 and January 2021 all consecutive patients receiving peripheral lithotripsy at our center were analyzed. Clinical and angiographic data were evaluated. Angiographic images were analyzed using a semiautomatic software for quantitative vessel analysis. Eighty-five lesions in 61 limbs were treated with IVL in 51 patients presenting with Rutherford classes 2 to 5. Most lesions (68%) were localized in the superficial femoral artery. Mean calcified lesion length was 102.5 mm (10–390 mm), with a median peripheral arterial calcium score of 3, indicating a highly calcified status. In 58% of the patients, IVL was used as a stand-alone therapy. IVL resulted in a mean acute luminal gain of 2.6 ± 0.9 mm, resulting in stenosis reduction by 42.1 ± 15%. Mean ankle brachial index (ABI) improved significantly from 0.6 to 0.8 (p < 0.0001) on day 1 after the intervention and remained stable at 6 months. This large real-world data of peripheral IVL reports compelling safety in a complex patient cohort. For the first time, clinical follow-up data demonstrated a sustained significant improvement in ABI after 6 months.

Keywords

intravascular lithotripsy - peripheral artery disease - calcification - single-center experience - ankle brachial index

Disclosures

No disclosures and no relationships with industry with all authors.


* Authors contributed equally to the work.




Publication History

Article published online:
25 August 2022

© 2022. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
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