TCT 2024: Shockwave Innovations

Chuck Simonton, M.D., talks to Nick West, M.D., the CMO at Shockwave, about what stood out for him at TCT 2024. “On the Shockwave front, we’ve had several exciting things,” Dr. West states. He explains that Shockwave’s main product is a calcium modification tool called intravascular lithotripsy (IVL) and that there’s a large overlap in both the physician users of IVL and Impella and also the patients requiring those therapies.

“We recently launched E8, which is a novel long balloon for use in the peripheral vasculature. So there’s been a lot of excitement around that. It’s something that the peripheral interventionalists have really been crying out for. Our devices have generally been much shorter up to this date.” Dr. West explains that E8  “addresses the problem of diffuse calcific disease, specifically in the fem-pop and infrapopliteal spaces.”

“What’s even more exciting is our new Javelin technology,” Dr. West tells Dr. Simonton. “All of our therapies to date have been balloon-based IVL, for both the coronary space and intravascular space.” He explains that Javelin, which launched in the peripheral space during the week of TCT, addresses an unmet need. “You can’t always cross a lesion with a balloon. And in those cases at the present time, physicians are left with the option of rotational or orbital atherectomy. We’ve now developed a catheter-based lithotripsy solution with a single emitter that is designed to abut these lesions and deliver the lithotripsy proximally to the cap, and then as you go through, deliver lithotripsy throughout the lesion.”

For interventional cardiologists working in the coronary space, Dr. West notes, “We are planning a Rapid Exchange version... The Rapid Exchange version will be part of the FORWARD CAD IDE, which will start in March of next year. But we’ve had some early feasibility data come in in the UK which is very encouraging.”

Dr. West provides some insights into how the Javelin works. He explains that the lithotripsy emitter was moved more distally to about as closely as possible to the lesion. The electrical current passes between 2 electrodes and sparks within a small, saline-filled chamber, enabling the formation of a vapor bubble that expands and a shockwave goes out from the leading edge of that spherical bubble.

“We have a lot more innovations that are coming,” Dr. West emphasizes, “So it’s a very exciting time for us.”