Intra Vascular Lithotripsy
Intra vascular lithotripsy system has emitters enclosed within the balloon which generates sonic pressure waves when delivered selectively disrupts and fractures calcium improving blood vessel compliance and stent delivery and expansion.
The IVL catheter is introduced into the target vessel and is positioned across the lesion, using the marker bands as guides, to ensure the circumferential therapeutic field effect created by the emitters is adjacent to the calcium. The IVL catheter is connected via a connector cable to the generator that is preprogrammed to deliver 10 pulses in sequence at a frequency of 1 pulse/s for a maximum of 80 pulses per catheter.
What and How?
Advanced age, diabetes mellitus, hypertension, and renal insufficiency contribute to high incidence of calcium deposition in blood vessels. Coronary calcification may impede stent delivery and deployment, leading to suboptimal stent expansion and stent failure. Atheroablative technologies act only on the superficial calcium. Intravascular lithotripsy (IVL) is a novel technique based on an established treatment strategy for renal calculi, in which multiple lithotripsy emitters deliver localized pulsatile sonic pressure waves to circumferentially fracture superficial and deep vascular calcium.
When angiogram shows heavy calcium, angioplasty is challenging as with stents cannot be delivered and even of delivered, they do not expand. In patients with heavy calcium IVL helps to fracture the calcium and then allows stent delivery and good expansion. Many patients who were refused stents earlier are now safely treated using this technology
Who does it?
Intra vascular Lithotripsy is a novel procedure and Dr Sengottuvelu was the earliest to start in India in January 2020 and he is now a highly experienced operator and uses several combinations of such devices to treat difficult and challenging procedures to get the best outcomes.