C-29 | Peripheral Artery Intravascular Lithotripsy: A Systematic Review

Abstract

Intravascular lithotripsy (IVL) has emerged as a novel endovascular therapy for treating PAD. Therefore, we sought to review the literature to assess the efficacy and safety of IVL in treating calcified PAD lesions. We searched PubMed, Embase, and Cochrane central for studies evaluating IVL in PAD. Patient characteristics, lesion characteristics, pre- and post-procedure diameter stenosis, complications, and IVL rates were evaluated. A total of 114 studies were found, out of which nine studies were included in the final analysis. There were a total of 777 patients, of which 66% (515/777) were males. The mean age was 74.8 years (SD 1.47). The mean length of the lesions was 62.54 mm (SD 12.4), with a mean calcified length of 92.13 mm (SD 17.22) and a mean reference vessel diameter (RVD) of 6.27 mm (SD 0.59). The mean pre-procedure diameter percentage stenosis was 72.61% (SD 6.05) and the mean post-procedure diameter stenosis was 22.81% (SD 1.71), with a mean acute gain of 6.96 mm (SD 0.91). IVL was successfully delivered in 89% of the lesions. Complications from the procedure included dissection (7.2%), perforation (0.4%) and embolization (0.13%). There were no incidents of thrombus, no reflow, or abrupt closure. IVL is safe and effective, with high clinical success in patients with difficult-to-treat moderate and severely calcified PAD lesions.