Dear readers,

Intravascular lithotripsy (IVL) continues to show an amazing track record with regard to safety in the coronary interventional space. The attached study published in the American Journal of Cardiology last month shows an impressive safety profile for IVL, which induced three times less perforations than rotational atherectomy, based on the PROGRESS-CTO registry analysis.

Another study published in Circulation Cardiovascular Interventions showed that based on electron microscopy analysis, the polymer integrity of freshly implanted, durable polymer drug-eluting stents can be significantly altered by laser atherectomy in contrast and high-pressure angioplasty. However, it remained preserved after IVL.

Besides continued evidence of its remarkable safety in the coronary space, exciting new IVL technologies have recently emerged in the peripheral space and were presented at the TCT 2024 (October) and VIVA 2024 (November) meetings. This includes a balloon-less front-acting crossing catheter (Javelin-Johnson and Johnson) and a new Laser/optics-based IVL catheter (BOLT medical), which uses a completely different mechanism for acoustic pressure wave generation. Both technologies have shown good safety and efficacy data as detailed in the attached articles.

The hope of the interventional cardiology community is to see these technologies being studied in the coronary space, to enhance the ever-growing therapeutic armamentarium for complex and heavily calcified coronary lesions.

Best,

Hady Lichaa, MD, FACC, FSCAI, FSVM, RPVI