Published online Aug 26, 2023. doi: 10.4330/wjc.v15.i8.395
Peer-review started: March 12, 2023
First decision: June 15, 2023
Revised: June 25, 2023
Accepted: July 24, 2023
Article in press: July 24, 2023
Published online: August 26, 2023
Processing time: 162 Days and 3.1 Hours
Intravascular lithotripsy (IVL) is a novel technique increasingly used for plaque modification and endovascular revascularization in patients with severe calcification and peripheral artery disease. However, much of the available literature on IVL is focused on its use in coronary arteries, with relatively limited data on non-coronary artery use.
To analyze the safety and efficacy of current IVL use in non-coronary artery lesions, as reported in case reports and case series.
We searched EMBASE, PubMed, and Reference Citation Analysis databases for case reports and case series on IVL use in peripheral artery disease. We then extracted variables of interest and calculated the mean and proportions of these variables.
We included 60 patients from 33 case reports/case series. Ninety-eight percent of the cases had IVL usage in only one blood vessel, while four had the IVL used in two vessels (2.0%), resulting in 64 Lesions treated with IVL. The mean age of the patients was 73.7 (SD 10.9). IVL was successfully used in severe iliofemoral artery stenosis (51.6%), severe innominate, subclavian, and carotid artery stenosis (26.7% combined), and severe mesenteric vessel stenosis (9.4%). Additionally, IVL was successfully used in severe renal (7.8%) and aortic artery (4.7%) stenosis. There were complications in 12% of the cases, with dissection being the commonest.
IVL has successfully used in plaque modification and endovascular revascularization in severely calcified and challenging lesions in the iliofemoral, carotid, subclavian, aorta, renal, and mesenteric vessels. The most severe but transient complications were with IVL use in the aortic arch and neck arteries.
Core Tip: Intravascular lithotripsy (IVL) has emerged as a novel endovascular therapy for treating severe vascular calcifications. In this review of case reports, we assessed the efficacy and safety of IVL in treating calcified lesions in non-coronary artery vessels and the various situations in which IVL was used in these vessels. We found that IVL has successfully facilitated treating severely calcified and challenging lesions in the iliofemoral, carotid, subclavian, aorta, renal, and mesenteric vessels.