Treating patients with severe calcification is a challenge in the treatment of PAD. In this short yet interesting video, Prof Konstantinos Donas (Asklepios Clinic Langen, DE) presents a real life case of a patient with severe calcification and subtotal occlusion of the femoral artery. Here he highlights, how he approaches the problem and talks through the treatment process using the Shockwave Lithoplasty® System.

Interviewer and Videographer: David Ramsey

Transcript Below :

Hello my name is Konstantinos Donas, I am vascular surgeon and head of the department of vascular surgery in the Asklepios Clinic in Langen, University of Frankfurt, in Germany. 

I would like to introduce you to a very nice case of a patient with severe calcification and subtotal occlusion of the superficial femoral artery. There is no doubt that calcification is always a big challenge in the treatment of PAD. Up to now, we don't have a clear, let's say, holy grail of the treatment of lesions with severe calcification. And in this context, we would like to present you a very nice case which treated last week here in my department. We see here in this image the Shockwave balloon, the Shockwave balloon is, as we can see here very nicely, a catheter, which would be inserted over a 0.014" wire in the superficial, in this case, femoral artery. And we have the possibility, first of all to expand the balloon to 4 atm to facilitate efficient energy transfer. And up to this it would be created and generated sonic pressure waves. And over these mechanism the goal is to modify the plaque to change the compliance as we say of the plaque minimising the risk of dissections and also need for stent placement. Here you can see images during the procedure from our hybrid room, in our department. And here is, you see here the balloon, we can hear how it hears, the typical sound, during the procedure, and sending the waves modifying the plaque within the calcification. Now I can show you the super selective angiography of the superficial femoral artery and you see several segmental calcified lesions with also subtotal occlusion in the distal part of the SFA. And after recanalization and performance of the Shockwave ballooning we can see here the final result. You see a very nice results without evidence of recoil or dissection with a very nice flow. Also in our bleak projection, no evidence of dissection are very nice results without the need to deploy additional stent placement after the treatment with a shockwave balloon. Thank you very much.