We describe a transcatheter aortic valve implantation in a patient with multiple comorbidities, including important bilateral iliac stenosis and severe aortic stenosis, with high surgical risk, in whom femoral access was contraindicated due to subocclusive stenosis of the common iliac artery and intense calcification. A new endovascular treatment modality was employed by intravascular lithotripsy with a balloon cathether Shockwave®, which enabled treating the common iliac artery together with the valve implantation, allowing to advance a deployment system of a self-expandable aortic valve prosthesis, with good results and successful procedure.
Intravascular lithotripsy providing femoral vascular access as adjuvant therapy to transcatheter aortic valve implantation
Dallan,Luis Augusto Palma and Main,Anthony and Baeza,Cristian and Attizzani,Guilherme Ferragut. Intravascular lithotripsy providing femoral vascular access as adjuvant therapy to transcatheter aortic valve implantation. J Transcat Intervent [online]. 2019, vol.27, [cited 2026-04-24], Available from: <https://jotci.org/article/intravascular-lithotripsy-providing-femoral-vascular-access-as-adjuvant-therapy-to-transcatheter-aortic-valve-implantation/>. ISSN . http://doi.org/10.31160/JOTCI201927A201908.
Dallan,Luis Augusto Palma; Main,Anthony; Baeza,Cristian; Attizzani,Guilherme Ferragut. Intravascular lithotripsy providing femoral vascular access as adjuvant therapy to transcatheter aortic valve implantation. J Transcat Intervent, v.27, Dec. 2019. Available from: <https://jotci.org/article/intravascular-lithotripsy-providing-femoral-vascular-access-as-adjuvant-therapy-to-transcatheter-aortic-valve-implantation/>. acess on 24 Apr. 2026. http://doi.org/10.31160/JOTCI201927A201908.
Dallan,Luis Augusto Palma, & Main,Anthony, & Baeza,Cristian, & Attizzani,Guilherme Ferragut. (2019). Intravascular lithotripsy providing femoral vascular access as adjuvant therapy to transcatheter aortic valve implantation. J Transcat Intervent, 27, http://doi.org/10.31160/JOTCI201927A201908.
DallanLuis Augusto Palma, MainAnthony, BaezaCristian, AttizzaniGuilherme Ferragut. Intravascular lithotripsy providing femoral vascular access as adjuvant therapy to transcatheter aortic valve implantation. J Transcat Intervent [Internet]. 2019 Dec [cited 2026 Apr 24]; 27: Available from: https://jotci.org/article/intravascular-lithotripsy-providing-femoral-vascular-access-as-adjuvant-therapy-to-transcatheter-aortic-valve-implantation/. http://doi.org/10.31160/JOTCI201927A201908.
Figure 3
Angiography. (A) Deployment (arrow) of the self-expandable prothesis CoreValve Evolut R 34mm (Medtronic®, Santa Rosa, CA, USA). (B) Result at the bifurcation of the common iliac artery after treatment with intravascular lithotripsy (arrow).