Calcium
C2+
IVL
Peripheral Catheters
Misc.
100
Length of C2+
12mm
100
What does IVL stand for?
Intravascular Lithotripsy
100
What do the letters & numbers mean for each peripheral catheter? (S4, M5+, L6)
S4= Small & 4 emitters
M5+= Medium & 5 emitters
L6 = Large & 6 emitters
100
Coronary IVUS crosses the lesion.. will SWAV cross?
C2+ has a smaller crossing profile than Coronary IVUS. What are some methods to aid in crossability?
200
The risks and complications associated with problematic calcium
Dissections, perforations, vessel recoil, embolization, stent crush, limited access for large-bore devices
200
Total pulses in C2+
120 pulses
200
3 components of the Shockwave system
Generator, connector cable, intuitive catheter
200
Which SWAV catheter line would you select to treat a highly calcified large iliac prior to a TAVR?
L6
300
Calcium presents in 3 types of morphologies
300
What diameters is C2+ available in?
2.5, 3.0, 3.5, 4.0
300
What is the proper technique to prep a SWAV catheter?
Remove stylet + balloon cover. Flush wire port. 2-3 negative preps, purge all air bubbles
300
What is the proper sizing ratio for all SWAV peripheral catheters?
1.1:1
UNDERSIZED = UNDERWHELMED
300
List the calcium modification tools that are currently on the market
400
Explain why Nodular & Eccentric calcium may take more pulses to effectively modify versus Concentric calcium
Balloons preferentially expand away from calcium, therefore the IVL emitters will do the same.
400
Research shows that C2+ is effective in what type of calcium?
Eccentric, Concentric, Nodular, Deep, Superficial.. ALL TYPES!
400
Each pulse delivers an effective pressure of..
~ 50 atm
= 735 psi
400
How many pulses does S4 have?
160 pulses, 8 cycles, 20 pulses per cycle
400
The energy profile of all 6 emitters on the L6 catheter are equal to which emitter on another catheter line?
The center emitter of M5+
500
If SWAV is fracturing the calcium, what's stopping it from floating downstream?
Internal Elastic Lamina. SWAV clinical data shows a less than 1% in distal embolization, perforations & dissections.
500
A physician is treating 2 lesions in the same vessel with a SWAV catheter. She starts with the distal lesion first. Why might she do this?
A distal lesion is tighter and a winged SWAV balloon catheter might not cross. Pulse management, etc.
500
Explain Shockwave's "Mechanism of Action" - how are the pulses delivered?
A semi-compliant balloon with gentle wall apposition, filled with a 50/50 mixture of saline & contrast, produces rapidly expanding & collapsing vapor bubbles
500
What wire diameter and length is required for M5+ & S4?
.014 and 300cm
500
How do you troubleshoot an error code on the generator?
Restart generator. Purge air from balloon. Reestablish connection.