Intravascular lithotripsy (IVL) has shown to be an effective alternative to traditional atherectomy procedures such as excisional, laser ablation or rotational atherectomies (RAs); it works by delivering a catheter to the heart through a small incision in the patient’s arm or leg by the doctor. Once the catheter is at the appropriate location, the lithotripsy emitter at the end of the catheter uses pressure waves in order to break up any calcified plaque that may be inhibiting blood flow to the heart.

It has also been noted that IVL is easier to learn and may be a more readily adopted surgical method compared to other available procedures. According to a study conducted by the National Heart Centre Singapore (NHCS), which compared the performance of IVL and RA procedures on heavily calcified coronary lesions, IVL procedures performed with similar effectiveness to the RA procedures based on the angiographic success rates. The study also found that IVL required shorter fluoroscopy times.

Being the only player in a novel medical device market, Shockwave Medical has positioned itself well in the percutaneous transluminal angioplasty (PTA) and percutaneous transluminal coronary angioplasty (PTCA) balloon catheter markets with each market increasing year over year, although the overall atherectomy market is declining.

Shockwave Medical has shown immense growth as a result of its dominance in IVL. Having products for both peripheral and coronary IVL catheters, Shockwave has gained huge market shares in the PTA and PTCA balloon catheter markets, making up an estimated 49.8% and 60.1% of the Q3 2022 market shares, respectively, according to GlobalData. The largest contributor to Shockwave Medical’s growth is the Shockwave C2 coronary IVL catheters which were first approved by the FDA in February 2021 and have since become a major asset to the company.

The advantages of using IVL compared to other atherectomy methods, in terms of its efficiency and short learning curve while maintaining a comparable efficacy, may lead to IVL replacing traditional atherectomy procedures for the general patient population. Although it is still early and further studies are required to be conducted in order to validate the wide-spread adoption of this booming technology, IVL has proven to be a legitimate surgical alternative with Shockwave Medical leading the way.

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