Back to 2025 Display Posters
Early And Mid-term Results After Adjunct Intravascular Lithotripsy Of Iliac Arteries And Aorta
Yasser Almadani, M.D
1, Indrani Sen, M.B.B.S
1, Andrew J. Meltzer, M.D, M.B.A
2, Fahad Shuja, M.B.B.S
3, Young M.D Erben
4, Thomas Carmody, M.D
1, Tiziano Tallarita, MD
1.
1Mayo Clinic Health System, Eau Claire, WI, USA,
2Mayo Clinic, Phoenix, AZ, USA,
3Mayo Clinic, Rochester, MN, USA,
4Mayo Clinic, Jacksonville, FL, USA.
OBJECTIVES: To evaluate the feasibility and safety of the peripheral Intravascular Lithotripsy (IVL) system in the treatment of severely stenotic iliac arteries and aorta for symptomatic peripheral arterial disease (PAD) or to enable performing Endovascular Aneurysm Repair (EVAR) and Transcatheter Aortic Valve Replacement (TAVR).
METHODS: Demographics, clinical
presentation, procedural details, and postoperative outcomes were retrospectively analyzed in consecutive patients (January 2021 to June 2024) undergoing adjunct IVL for severe stenosis of the iliac arteries and aorta
. Primary outcomes were technical success and peri-procedural major adverse events. Technical success was defined as successful delivery of device or endograft for EVAR/TAVR or residual stenosis <30% for PAD. Secondary outcomes were mid-term patency and need for re-intervention.
RESULTS: Thirty patients (median age = 75 years, range 56 - 94; male gender 16, 53%) with one or more severe stenosis of the common iliac artery (n=26, 87%) external iliac artery (n=14, 47%) and/or the aorta (n=3, 10%) were treated for symptomatic PAD (n=23,77%) or to facilitate transfemoral EVAR or TAVR (n=7, 23%). Symptoms for PAD were claudication (18, 60%) or chronic limb threatening ischemia (5,17%) and the lesions were classified as Transatlantic Inter-Society Consensus II A in 3 (10%), B in 6 (20%), C in 8 (27%), and D in 6 (20%). Median lesion length treated was 5 cm (range 2 - 13.5 cm). Twenty-six lesions (87%) were stented after IVL, while in 4 patients (13%) IVL was used alone to allow intravascular access for two EVAR (6.5%) and two TAVR (6.5%). The success rate was 100% with no intra-procedural complications and median hospital stay of 1 day (range 0 - 17). One patient (3%) developed acute iliac occlusion twenty-four days after left common iliac artery IVL and stenting, requiring thrombectomy with re-stenting of the common iliac and new stenting of the external iliac arteries. After a median follow up of 9.5 months (range 1-22), six patients (20%) died for non-vascular related diseases. One-year primary patency rate was 95% ±3 and there were no late re-interventions.
CONCLUSIONS: IVL for symptomatic PAD or to facilitate transfemoral EVAR/TAVR was safe with 100% procedural success rate, low risk of intraoperative complications, and mid-term primary patency of 95%. Further studies are needed to assess the long-term effectiveness of the IVL system.
Back to 2025 Display Posters
