PMID- 37491522
OWN - NLM
STAT- MEDLINE
DCOM- 20230904
LR  - 20230927
IS  - 1432-086X (Electronic)
IS  - 0174-1551 (Linking)
VI  - 46
IP  - 9
DP  - 2023 Sep
TI  - Outcomes of Intravascular Lithotripsy in the Treatment of Chronic 
      Limb-Threatening Ischemia: A Single-Center Retrospective Study.
PG  - 1214-1220
LID - 10.1007/s00270-023-03510-1 [doi]
AB  - PURPOSE: Vascular calcification is an important risk factor for endovascular 
      treatment failure and complications in patients with chronic limb-threatening 
      ischemia (CLTI). Intravascular lithotripsy (IVL) is a pulsatile balloon-based 
      device that has emerged as a tool in the treatment of calcified vessels. The 
      purpose of this study is to evaluate the efficacy and safety of IVL in the 
      treatment of peripheral calcified lesions in CLTI patients. MATERIALS AND 
      METHODS: A retrospective study was performed within a single institution. 
      Thirty-six CLTI patients treated with IVL for peripheral calcified lesions from 
      2018 to 2022 were identified. Data on pre- and post-IVL luminal stenosis measured 
      by digital subtraction angiography, lesion location, adjunctive therapies, 
      ankle-brachial index (ABI), and intra-procedural complications were obtained. A 
      total of 41 target lesions in twenty-eight patients were included, with ABI data 
      available in 20 treated lower extremities. RESULTS: Across all 41 target lesions, 
      IVL produced clinically significant luminal gain of 75.5% +/- 23.0. Luminal gain by 
      vessel location was 87.3% +/- 15.8, 57% +/- 25.7, and 78.5% +/- 20.6 in the aortoiliac 
      (n = 8), common femoral (n = 9), and femoropopliteal (n = 24) segments, 
      respectively. Lesions treated with IVL alone yielded a luminal gain of 
      71.4% +/- 25.6 (n = 10), while IVL alongside adjunctive therapy produced a luminal 
      gain of 76.8% +/- 22.4. In 20 treated lower extremities, ABI improvement of 
      0.20 +/- 0.26 (p = 0.002) was recorded. Intra-procedural complications occurred in 
      1/36 patients, which was one instance of thrombus occurring prior to IVL. 
      CONCLUSION: IVL may be an effective option for creating safe luminal gain and 
      vessel preparation in patients with CLTI. Level of Evidence 2: Retrospective 
      Cohort Study.
CI  - (c) 2023. Springer Science+Business Media, LLC, part of Springer Nature and the 
      Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
FAU - Salazar, Samuel A
AU  - Salazar SA
AD  - Herbert Wertheim College of Medicine, Florida International University, Miami, 
      FL, USA.
FAU - Vengalasetti, Yasaswi
AU  - Vengalasetti Y
AD  - Department of Epidemiology and Population Health, Stanford University School of 
      Medicine, Stanford, CA, USA.
FAU - Kilbridge, Matthew
AU  - Kilbridge M
AD  - Department of Interventional Radiology, Miami Cardiac and Vascular Institute, 
      Baptist Health South Florida, Miami, FL, USA.
FAU - Gurusamy, Varshana
AU  - Gurusamy V
AD  - Department of Interventional Radiology, Medical University of South Carolina, 
      Charleston, SC, USA.
FAU - Powell, Alex
AU  - Powell A
AD  - Department of Interventional Radiology, Miami Cardiac and Vascular Institute, 
      Baptist Health South Florida, Miami, FL, USA.
FAU - Schiro, Brian J
AU  - Schiro BJ
AD  - Department of Interventional Radiology, Miami Cardiac and Vascular Institute, 
      Baptist Health South Florida, Miami, FL, USA.
FAU - Pena, Constantino S
AU  - Pena CS
AD  - Department of Interventional Radiology, Miami Cardiac and Vascular Institute, 
      Baptist Health South Florida, Miami, FL, USA.
FAU - Gandhi, Ripal T
AU  - Gandhi RT
AD  - Department of Interventional Radiology, Miami Cardiac and Vascular Institute, 
      Baptist Health South Florida, Miami, FL, USA.
FAU - Niekamp, Andrew S
AU  - Niekamp AS
AD  - Department of Interventional Radiology, Miami Cardiac and Vascular Institute, 
      Baptist Health South Florida, Miami, FL, USA. andrewsn@baptisthealth.net.
LA  - eng
PT  - Journal Article
DEP - 20230725
PL  - United States
TA  - Cardiovasc Intervent Radiol
JT  - Cardiovascular and interventional radiology
JID - 8003538
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - Chronic Limb-Threatening Ischemia
MH  - Treatment Outcome
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - *Lithotripsy/adverse effects
OTO - NOTNLM
OT  - Chronic limb-threatening ischemia
OT  - Critical limb ischemia
OT  - Intravascular lithotripsy
OT  - Peripheral arterial disease
OT  - Vessel calcification
EDAT- 2023/07/26 01:06
MHDA- 2023/09/04 06:42
CRDT- 2023/07/25 23:56
PHST- 2023/03/02 00:00 [received]
PHST- 2023/07/05 00:00 [accepted]
PHST- 2023/09/04 06:42 [medline]
PHST- 2023/07/26 01:06 [pubmed]
PHST- 2023/07/25 23:56 [entrez]
AID - 10.1007/s00270-023-03510-1 [pii]
AID - 10.1007/s00270-023-03510-1 [doi]
PST - ppublish
SO  - Cardiovasc Intervent Radiol. 2023 Sep;46(9):1214-1220. doi: 
      10.1007/s00270-023-03510-1. Epub 2023 Jul 25.