SHOCKWAVE THERAPY
Shockwave therapy is a technique that uses sonic waves to break up calcified plaque in the arteries for improved stent expansion
Shockwave Therapy & Dr Khan's Expertise
Shockwave therapy or Intravascular lithotripsy (IVL) is a new vessel preparation technique for calcified coronary artery lesions that creates multiplane micro/macro fractures in the calcified plaque before stenting or allowing for an improved stent expansion.
Dr Khan is one of the earliest pioneers of Shockwave Therapy in the state of Canberra, and is highly knowledgable and experienced in this procedure. He has performed Shockwave therapy (IVL) in over 20 patients with extremely stellar patient outcomes post-procedure.
Why do we use it?
Coronary artery calcification is a pathological deposition of calcium in the intimal and medial layer of the arterial wall. Shockwave intravascular lithotripsy (IVL) has evolved as a new modality to treat heavily calcified coronary arteries. IVL involves using a percutaneous device to produce acoustic pressure waves resulting in the delivery of sufficient energy to break up superficial and deep calcium deposits.
The amount of coronary artery calcification increases with age and the presence of cardiovascular risk factors and comorbidities. Up to 20% of percutaneous coronary intervention (PCI) procedures are challenged by severe calcifications, and coronary calcifications have been shown to be an independent predictor of PCI failure and future adverse cardiac events.
Lesion calcification increases procedural complexity and time. More specifically, calcium localisation (superficial or deep), distribution (focal, circumferential and longitudinal extension) and thickness influence procedural success, stent delivery and deployment.
The Procedure
The procedure is typically performed under local anesthesia, and it takes about 30 minutes to 1 hour to complete. During the procedure, a small cut (incision) is made on the hands or legs of patients to deliver a catheter into the heart. Lithotripsy emitters at the end of the catheter emits sound waves to breakup the calcification. This allows the blood vessels to open when a balloon (angioplasty) if inflated in the vessel to subsequently allow for the stents to be put in place.
Clinical Evidence
The coronary IVL system has received both the CE Mark and FDA approval. IVL has been studied in the Disrupt CAD clinical trials, including the pivotal Disrupt CAD III study. The most recent data confirms that IVL is a safe procedure with a high success rate – primary safety and effectiveness endpoints were achieved in 92.7% and 92.4% in the pooled analysis of all Disrupt clinical trials.
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