Is Intravascular Lithotripsy (IVL) Alone a Therapy for the Treatment of Aortoiliac Occlusive Disease (AIOD)?

We present a rare case in which a 63-year-old male with a history of hypertension, diabetes mellitus, hyperlipidemia, and previous coronary artery bypass graft (CABG) presented with bilateral external iliac artery near occlusion. We describe the utilization of lithotripsy balloon angioplasty as opposed to the traditional double-barrel stenting method or modified endovascular repair (EVAR) to treat the occlusion. Pre-operative computed tomography (CT) angiography demonstrated a 90 percent occlusion of both the distal aorta and right external iliac artery, and 99 percent occlusion of the left external iliac. The patient remains symptom-free three years post-intervention with normal right and left ankle-brachial indices, 1.34 and 1.32 respectively. We review the available literature regarding aortoiliac occlusive disease (AIOD) and discuss the advantages and disadvantages of novel and traditional treatment modalities. Understanding all treatment options is crucial for physicians who are presented with similar cases.