Giacomo Isernia (Perugia, Italy) sits down with Vascular News to discuss the challenges posed by calcium when it comes to endograft delivery. Calcium “limits the ability to choose the proper graft for each patient,” states Isernia. “This is a pity as we want to treat the patient in the best possible way and want to choose the proper graft for each vascular anatomy,” he adds.
Isernia discusses the possible tools and techniques that are available to overcome calcium and highlights the importance of vessel compliance. He offers up his own experience using Shockwave Intravascular Lithotripsy (IVL; Shockwave Medical) to combat the problem of calcium in a patient with a 55m pararenal aneurysm and outlines why “in this specific type of patient IVL is our gold-standard therapy”.
The use of IVL in this case led to “very nice patency” and no dissection, perforation or complication at the level of both common iliac arteries. “IVL technology needs to be in the armamentarium of all surgeon who are dealing with endovascular complex aortic repair because vascular access represents probably one of the last limitations in applying this kind of innovative technology. We need this new approach because it is safe, easy, quick and, in particular, solves the big problem of calcium in both common and external iliac arteries for our patients,” concludes Isernia.
This video is sponsored by Shockwave Medical.
Read Giacomo Isernia‘s article: Shockwave IVL: The last piece of the puzzle to overcome the challenge of hostile calcified access in complex endovascular aortic management