INTRAVASCULAR LITHOTRIPSY: THERAPEUTIC AND DIAGNOSTIC APPLICATIONS IN HYPERTENSIVE PATIENTS WITH CORONARY CALCIFIED LESIONS

Background: Intravascular lithotripsy (IVL) is an innovative method for treating heavily calcified coronary and peripheral lesions. It employs acoustic shock waves to create microfractures in calcified plaques, facilitating stent placement and improving vessel compliance. Objective: To assess the efficacy, safety, and potential applications of IVL in hypertensive patients with calcified coronary lesions, while exploring its diagnostic and therapeutic capabilities. Methods: A thorough review of the latest advancements and studies on IVL, with a focus on its use in hypertensive patients. Key studies, including the Disrupt CAD series, were analyzed for procedural success, safety, and clinical outcomes. The integration of IVL with imaging techniques such as intravascular ultrasound (IVUS) was also investigated. Results: IVL has shown high procedural success rates and minimal complications in treating calcified coronary and peripheral lesions. Studies have reported significant luminal gain post-IVL, with minimal residual stenosis. The Disrupt CAD studies confirmed the safety and efficacy of IVL, with minimal adverse events and substantial calcium fracture in treated lesions. IVL’s effectiveness in managing specific clinically significant lesions, such as left main and nodular calcium lesions, was also demonstrated. Conclusion: IVL is a promising technology for modifying severely calcified coronary lesions, particularly in hypertensive patients. It enhances stent expansion and reduces complications associated with traditional atherectomy. The combination of IVL with advanced imaging techniques provides a personalized approach to treating calcified vascular diseases, improving patient outcomes and expanding therapeutic options.