AB008. SOH25_AB_314. Video analysis of intra-operative intravascular lithotripsy: a case series

Background: Intravascular lithotripsy (IVL) has the potential to revolutionise endovascular intervention. IVL is an innovative therapy for the management of heavily calcified coronary and peripheral arterial lesions. IVL targets areas of significant arterial calcification with sonic pressure waves, disrupting the sub-intimal calcium and increasing patency of the artery. IVL allows for significant revascularization during a minimally-invasive procedure, sparing patients the morbidity and potential complications of more invasive interventions. This study evaluates procedural and clinical outcomes through video analysis of six patients undergoing IVL for severe lower limb, arterial calcification.

Methods: A retrospective review was conducted on procedural videos from six patients with peripheral disease treated with IVL. Intra-operative footage via digital subtraction angiography (DSA) was used to assess the effects of IVL in real time. Intra-operative notes and patient charts were reviewed to assess clinical outcomes, including procedural success, complications, and post-procedure symptom resolution.

Results: All patients demonstrated successful IVL therapy, evidenced by significant luminal gain and effective calcium fracture in high-burden calcified lesions. Balloon expansion was achieved in 100% of cases. No major procedural complications (e.g., perforation, embolization) were noted. Post-procedure, patients reported symptomatic improvement.

Conclusions: Video analysis provides valuable insights into IVL efficacy, demonstrating consistent success in luminal gain in patients with severe arterial calcification. Future studies with larger cohorts and long-term follow-up are warranted to validate these findings and optimize IVL protocols.

Keywords: Intravascular lithotripsy (IVL); arterial calcification; endovascular intervention; peripheral arterial disease; video analysis