IntraVascular Lithotripsy: IVL

     Although the number of patients undergoing percutaneous coronary intervention (PCI) for coronary artery disease is increasing, problems during treatment are still encountered. Vascular calcification (plaque) is one such problem. Currently, medical technology has developed an innovation to break down calcification in blood vessels (IVL: Intra Vascular Lithotripsy), which helps the treatment proceed more smoothly.

IVL: IntraVascular Lithotripsy

     IVL: IntraVascular Lithotripsy is a treatment for coronary artery stenosis via a catheter, which sends sound waves through a balloon to areas with high hardness or resistance in the blood vessel, such as calcification. The affected material breaks into small pieces without affecting the surrounding tissue. This treatment therefore makes the blood vessel more flexible and facilitates subsequent stenting.

Which cases use IVL technology?

• Coronary artery disease caused by thick calcification: It can break down deep calcium deposits and reduce trauma to surrounding tissues compared to treatment with high-pressure balloons. It is also an option for patients who have previously had stents placed but could not achieve full expansion due to thick calcification.
• Peripheral artery disease (PAD) due to thick calcification: Especially in key areas that carry blood to the lower body, such as the iliofemoral, femoropopliteal, and infrapopliteal arteries.
• Patients with chronic limb pain: Used in patients with chronic limb-threatening ischemia (Rutherford class 4-6) who have severely accumulated calcification.
• Preparing blood vessels for other treatments: Especially in major blood vessels, such as the Abdominal Aorta and Aortic Arch, to facilitate subsequent procedures like Transcatheter Aortic Valve Replacement (TAVR) or Endovascular Aneurysm Repair (EVAR, TEVAR).

Advantages of IVL

• Can address deep calcium deposits in the blood vessel.
• Reduces trauma to surrounding tissues compared to treatment with high-pressure balloons.
• Facilitates the passage of various devices and reduces the chance of restenosis (re-narrowing).
• Helps patients recover quickly and reduces recovery time (1-2 days hospital stay).

Care after IVL treatment

Care during the hospital stay (Approximately 1-2 days)

• Lie flat and do not bend the leg on the side of the procedure for approximately 6-10 hours.
• Observe for abnormal symptoms at the wound site, such as bleeding, pain, swelling, redness, heat, numbness, or pallor/coldness in the area. If symptoms occur, the patient should inform the doctor and nurse immediately.
• Slowly get up to sit or stand. Avoid coughing or straining during bowel movements.
• Drink plenty of water (about 1-1.5 liters) to help flush the contrast agent out through urine.
• Eat normally if there are no dietary restrictions based on the doctor's treatment plan.

Care after discharge

• Protect the wound from water for about 3 days. If exposed to water, wipe with Betadine.                 
• Avoid exercise or heavy lifting for the first 1-2 weeks.
• Avoid lifting objects heavier than 5 kilograms for about 1 month.
• See a doctor immediately if you experience chest tightness/pain.
• Take medications regularly as advised by the doctor, such as anticoagulant medication.
• Attend follow-up appointments with the doctor for check-ups and monitoring.