Intravascular Lithotripsy (IVL) is an advanced coronary intervention used to treat severely calcified coronary artery lesions. It uses controlled sonic pressure waves to fracture calcium within the vessel wall, allowing safe balloon expansion and optimal stent deployment.
IVL uses acoustic shock waves to safely fracture coronary calcium and enable optimal stent expansion with minimal vessel trauma.
Severe coronary calcium prevents adequate balloon expansion, proper stent delivery, and long-term success of angioplasty. These calcified lesions are commonly seen in elderly patients, long-standing diabetes, chronic kidney disease, and left main or bifurcation lesions.
- Elderly patients with heavy coronary calcium
- Long-standing diabetes or chronic kidney disease
- Poor balloon expansion due to calcification
- Stent under-expansion caused by calcium
- Left main and bifurcation coronary lesions
- Need for safe and effective calcium modification
What Is Intravascular Lithotripsy (IVL)?
IVL uses a special balloon catheter with integrated emitters that deliver acoustic shock waves similar to kidney stone lithotripsy. These waves fracture both deep and superficial calcium while preserving soft vessel tissue.
Severe coronary calcium prevents adequate balloon expansion, proper stent delivery, and long-term success of angioplasty, making IVL essential for safe calcium modification.
After angiography identifies the calcified lesion, the IVL balloon is positioned and inflated at low pressure (4–6 atm). A series of sonic pulses fracture calcium, improving vessel compliance before stent implantation.
IVL is recommended for moderate to severe calcified lesions, stent under-expansion due to calcium, left main disease, bifurcation lesions, and as an alternative or adjunct to rotablation.
IVL provides effective calcium modification with a lower risk of vessel injury, does not require high-speed burrs, has a short learning curve, and produces reproducible outcomes even in complex disease.
IVL has high procedural success and low complication rates in global trials. It improves long-term stent durability and is particularly effective for left main PCI.
Expert Intravascular Lithotripsy (IVL)
IVL offers a modern, safe, and effective solution for calcified coronary artery disease, enabling optimal stent expansion with minimal vessel trauma and excellent long-term outcomes.
