Treatment of a Heavily Calcified Celiac Artery Ostial Subtotal Occlusion Using Shockwave Lithotripsy: A Novel Approach.

MedStar author(s):
Citation: Cardiovascular Revascularization Medicine. 25:72-74, 2021 Apr.PMID: 32111558Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Interventional Cardiology FellowshipForm of publication: Journal ArticleMedline article type(s): Case ReportsSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021Local holdings: Available in print through MWHC library: 2002 - presentISSN:
  • 1878-0938
Name of journal: Cardiovascular revascularization medicine : including molecular interventionsAbstract: CASE REPORT: A 79-year-old woman presented with chronic post-prandial abdominal pain and weight loss. Selective angiography revealed a sub-totally occluded celiac artery. Percutaneous endovascular intervention of the celiac artery was attempted but was unsuccessful because of heavy calcification. The patient returned for a repeat procedure. A guidewire was successfully advanced across the sub-totally occluded ostium. A Shockwave Lithotripsy BDC 7.0-mm/60-mm balloon catheter (Shockwave Medical Inc., Santa Clara, California) was successfully used to modify the calcified plaque. Next, a stent was deployed for definitive therapy. The final angiogram showed an excellent result. The patient tolerated the procedure well and was sent home on dual antiplatelet therapy. Nine months after the procedure, she had gained weight and denied any further post-prandial abdominal pain.CONCLUSION: IVL treatment modality to modify calcified lesions in the splanchnic circulation should be considered as a novel approach to patients in whom traditional endovascular treatment modalities are thought to be suboptimal. Further controlled studies are needed to access the safety, feasibility, and efficacy of the use of this novel technology in this vascular territory. Copyright (c) 2020 Elsevier Inc. All rights reserved.PURPOSE: We present the novel use of adjunctive intravascular lithotripsy (IVL) before definitive intravascular stenting of a heavily calcified celiac artery ostial occlusion.All authors: Bernardo NL, Case BC, Cheng PVCY, Singh A, Waksman RFiscal year: FY2021Digital Object Identifier: Date added to catalog: 2021-06-28
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Journal Article MedStar Authors Catalog Article 32111558 Available 32111558

Available in print through MWHC library: 2002 - present

CASE REPORT: A 79-year-old woman presented with chronic post-prandial abdominal pain and weight loss. Selective angiography revealed a sub-totally occluded celiac artery. Percutaneous endovascular intervention of the celiac artery was attempted but was unsuccessful because of heavy calcification. The patient returned for a repeat procedure. A guidewire was successfully advanced across the sub-totally occluded ostium. A Shockwave Lithotripsy BDC 7.0-mm/60-mm balloon catheter (Shockwave Medical Inc., Santa Clara, California) was successfully used to modify the calcified plaque. Next, a stent was deployed for definitive therapy. The final angiogram showed an excellent result. The patient tolerated the procedure well and was sent home on dual antiplatelet therapy. Nine months after the procedure, she had gained weight and denied any further post-prandial abdominal pain.

CONCLUSION: IVL treatment modality to modify calcified lesions in the splanchnic circulation should be considered as a novel approach to patients in whom traditional endovascular treatment modalities are thought to be suboptimal. Further controlled studies are needed to access the safety, feasibility, and efficacy of the use of this novel technology in this vascular territory. Copyright (c) 2020 Elsevier Inc. All rights reserved.

PURPOSE: We present the novel use of adjunctive intravascular lithotripsy (IVL) before definitive intravascular stenting of a heavily calcified celiac artery ostial occlusion.

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