{
  "abstract": "Introduction Calcified carotid stenosis are difficult lesions to treat endovascularly. Stenting and angioplasty in extensive calcification increase the risk of complications such as stent malposition, under expansion, arterial dissection, and residual stenosis. Although intravascular lithotripsy is proven for coronary andperipheral calcifications, its use in calcified carotid stenosis remains off label with limited data. We present our experience and a systematic review to assess the safety and efficacy of this technique intreating calcified carotids.Methods This study combines PRISMA systematic review (PubMed, MEDLINE, Embase) of Intravascular Lithotripsy (IVL) for calcified carotid stenosis with retrospective review of our institutional IVL cases (March2024-sept 2025).Results Case series(n=15)Mean age was 71 ± 11 years with 60% female; all had hypertension & history of myocardial infarction.84.6% were symptomatic with 89.6 ± 6.7% stenosis. All procedures were performed via transfemoral access with proximal balloon and distal filters. The mean pulse count was 65 ± 10, using a coronary balloon (C2). No periprocedural strokes or myocardial infarctions were reported with 100% Procedural success (<30% stenosis).Systematic review(n=126). Fifteen studies comprising 126 patients (mean age 76.2) were included. Hypertension seen in 71.4%, prior to Myocardial infarction in 62%, and 41.3% were smokers. 83.4% were symptomatic, with82.39±6.0% stenosis. Route: transfemoral (36%), transcervical (70%), trans radial (4%). Proximal & distal filters were used in 87.6% and 90.4% respectively. The mean pulse count was 73.74±26.7. Peripheral balloons were used in 89% cases, coronary in 11%. Post-lithotripsy angioplasty used in 44.6% (95%CI0.36-0.56) with 100% procedural success. Stroke rate was 6% (0.016-0.10), MI 4% CI 0.01- 0.075), mortality 1.6% (CI 0-0.045).71%(n=86) had 6 month follow up.4.9%(CI0.01-0.08) (n=6) had developed in-stent stenosis which was treated with angioplastyConclusion Intravascular lithotripsy is a highly effective and safe procedure for treating severe calcified carotidstenosis. It is associated with minimal adverse events and long-term efficacy.Disclosures K. Arumalla: None. A. Sonig: None.Abstract E-146 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Neurovascular Institute, Willis Knighton Hspital, Shreveport, LA"
      ],
      "name": "K Arumalla"
    },
    {
      "affiliations": [
        "Neurovascular Institute, Willis Knighton Hspital, Shreveport, LA"
      ],
      "name": "A Sonig"
    }
  ],
  "title": "E-146 Intravascular lithotripsy for severe calcified carotid stenosis: a willis knighton health experience and systematic review",
  "uid": "d06ae135-7944-5010-9d77-22e01abac014"
}