Intravascular Lithotripsy Facilitated Percutaneous Endovascular Intervention of the Aortic Arch: A Single-Center Experience.
Citation: Cardiovascular Revascularization Medicine. 21(8):1006-1015, 2020 08.PMID: 32386683Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Aorta, Thoracic | *Brachiocephalic Trunk | *Carotid Stenosis/th [Therapy] | *Endovascular Procedures | *Lithotripsy | *Subclavian Artery | *Vascular Calcification/th [Therapy] | Aged | Aged, 80 and over | Aorta, Thoracic/dg [Diagnostic Imaging] | Brachiocephalic Trunk/dg [Diagnostic Imaging] | Carotid Stenosis/dg [Diagnostic Imaging] | Endovascular Procedures/ae [Adverse Effects] | Humans | Lithotripsy/ae [Adverse Effects] | Male | Middle Aged | Retrospective Studies | Severity of Illness Index | Subclavian Artery/dg [Diagnostic Imaging] | Treatment Outcome | Vascular Calcification/dg [Diagnostic Imaging]Year: 2020Local holdings: Available in print through MWHC library: 2002 - presentISSN:- 1878-0938
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 32386683 | Available | 32386683 |
Available in print through MWHC library: 2002 - present
BACKGROUND: Intravascular lithotripsy (IVL) (Shockwave Medical, Inc., Fremont, California, USA) is a novel technology used to modify heavily calcified atherosclerotic plaque in vessels to help facilitate percutaneous coronary intervention and has been shown to be effective in treating critical lesions within the lower limbs. In addition, studies are currently underway evaluating IVL's feasibility in de novo calcified stenotic coronary arteries before stenting. The use and associated complications of IVL in other vascular territories are underreported. We report our institution's initial experience using IVL for the treatment of complex, heavily calcified lesions within the aortic arch vessels.
CONCLUSION: IVL offers promising technology to facilitate the treatment of complex lesions in the vessels of the aortic arch. We do not promote the use of IVL but promote prospective clinical trials to assess the safety and efficacy of this technology in this vascular territory. Copyright (c) 2020 Elsevier Inc. All rights reserved.
METHODS AND RESULTS: We treated five patients with IVL of the aortic arch vessels, including the carotid (2), subclavian (2), and innominate arteries. Four of the five patients underwent successful IVL treatment and intervention without complications. One patient (carotid intervention) developed acute right eye blindness post-procedure, thought to be due to an embolic plaque, which was successfully treated with tissue plasminogen activator and intravenous heparin.
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