Parallel intravascular lithotripsy catheters technique for calcified atherosclerotic abdominal aortic stenosis

Abstract BACKGROUND: Calcified atherosclerotic abdominal aortic stenosis is a rare and challenging condition, with heavily annular calcification limiting the effectiveness of traditional endovascular treatments. METHODS: A 66-year-old female with severe abdominal aortic stenosis underwent treatment using a parallel intravascular lithotripsy (IVL) catheter technique. Bilateral femoral access and arterial embolization were followed by parallel IVL angioplasty, stent implantation, and postdilation. A swine model was used to assess vascular injury after parallel IVL. RESULTS: The parallel IVL technique significantly relieved the stenosis without complications, as confirmed by angiography. In the swine model, histological analysis showed no significant vascular injury, except for expected intimal disruption and elastic lamina stretching. CONCLUSION: Parallel IVL catheter angioplasty is a feasible and safe approach for heavily calcified abdominal aortic stenosis, warranting further studies to validate its long-term outcomes.