Intravascular Lithotripsy for Calcified Coronary and Peripheral Lesions: Scoping Review with ☸️SAIMSARA.

Name: SAIMSARA Evidence Object vascular::INTRAVASCULAR_LITHOTRIPSY_SS
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsaraf186a485

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Intravascular Lithotripsy for Calcified Coronary and Peripheral Lesions: Scoping Review with ☸️SAIMSARA.

Cardiac & Vascular Health

Issue 1, Volume 1, 2026

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DOI: 10.62487/saimsaraf186a485

Editorial note

• Last update: 2026-06-02 07:37:59

What is this paper about

This review shows that intravascular lithotripsy is no longer a niche calcium tool, but an expanding platform across coronary PCI, peripheral interventions, TAVR access, stent failure, and complex off-label vascular anatomy. The full read clarifies where IVL is best supported, where evidence is still case-based, and how procedural success, complications, imaging guidance, and long-term durability should shape real clinical use.

Human-verified editorial review Verified by World ID proof-of-human. This editorial layer was submitted from a SAIMSARA account verified as a unique human.

Generated with SAIMSARA 4.9

Abstract: To map and synthesize the original clinical, experimental, and translational evidence on intravascular lithotripsy (IVL), with emphasis on its dominant applications, procedural and clinical outcomes, mechanistic signals, safety considerations, and research gaps across vascular and structural cardiovascular settings. The review uses 207 references and builds its evidence map from 416 original studies with 3487513 total participants/sample observations (topic-deduplicated ΣN). Across the mapped evidence, IVL emerges as a broadly applicable calcium-modification strategy that consistently fractures vascular calcium, improves vessel compliance, and facilitates stent or device delivery with acceptable short-term safety, most robustly demonstrated in severely calcified coronary and femoropopliteal disease where procedural success commonly exceeds 90%. The recurring signal suggests IVL performs comparably to rotational atherectomy for stent expansion while offering potential procedural and microvascular advantages, and supports durable patency when paired with drug-coated balloons in peripheral disease. Practically, this positions IVL as a versatile lesion-preparation option that can be tailored through intravascular imaging, although uncommon complications and disparities in access warrant continued vigilance. The dominant uncertainty remains long-term comparative durability and optimal patient selection, and future adequately powered randomized trials with extended follow-up across coronary, peripheral, and emerging structural indications are needed to clarify IVL's definitive role.

Keywords: Intravascular lithotripsy; Calcified lesions; Coronary artery disease; Percutaneous coronary intervention; Stent expansion; Rotational atherectomy; In-stent restenosis; Optical coherence tomography; Major adverse cardiovascular events; Iliac occlusive disease

Review Stats

Final search date and database lock: 2026-05-22 21:13:14 CEST
Plan: Pro (expanded craft tokens; source: Semantic Scholar)
Source: Semantic Scholar
Total Abstracts/Papers: 130004
Downloaded Abstracts/Papers: 1000
Included original and non-original Abstracts/Papers (all): 505
Included original Abstracts/Papers (Vote counting by direction of effect): 416
Reference Index (links used in paper): 207
Total participants/sample observations (topic deduplicated ΣN): 3487513

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Reference Index (207)

[1] Dual-Prep registry: atherectomy devices and intravascUlAr lithotripsy for the PREParation of heavily calcified coronary lesions registry — https://doi.org/10.1007/s12928-025-01130-9
[2] Comparison of Vascular Injury From Intravascular Lithotripsy, Cutting, or Ultra-High-Pressure Balloons During Coronary Calcium Modification. — https://doi.org/10.1016/j.jcin.2025.06.035
[3] Incidence of Complications Following Coronary Intravascular Lithotripsy, Clinical Outcomes, and Predictors of Complications — https://doi.org/10.1016/j.jscai.2025.103706
[4] Mid-term Outcomes of Shockwave Intravascular Lithotripsy in the IVLIAC Registry for the Treatment of Calcified Iliac Occlusive Disease. — https://doi.org/10.1016/j.jvs.2025.04.025
[5] Advances in intravascular lithotripsy: mechanisms, devices, and clinical applications — https://doi.org/10.1080/17434440.2025.2472886
[6] Coronary Compliance Modification by Intravascular Lithotripsy: New Predictor of Stent Expansion in Calcified Coronary Lesions — https://doi.org/10.1016/j.jscai.2025.102635
[7] A Novel Intravascular Lithotripsy System in Severely Calcified Coronary Lesions: The Prospective COronary CAlcified Lesion Lithotripsy Procedure (COCALP) Study — https://doi.org/10.1002/mco2.70208
[8] Intravascular lithotripsy vs. rotational atherectomy on coronary microcirculation: a retrospective multicenter propensity-matched multicenter study — https://doi.org/10.3389/fcvm.2025.1560743

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