Ziad Ali explains how newer IVL technology can tackle more tortuous coronary anatomy

The newest coronary intravascular lithotripsy (IVL) catheter from Shockwave Medical, a Johnson & Johnson MedTech company, is officially here, and it was built to improve one of the technology’s biggest historical limitations: deliverability in a complex coronary anatomy.

In early May, Johnson & Johnson announced the official launch of the Shockwave C2 Aero Coronary IVL Catheter. To learn more about the new-look device, Cardiovascular Business spoke with Ziad Ali, MD, DPhil, director of the DeMatteis Cardiovascular Institute at St. Francis Hospital and Heart Center, about his center's early experience using it treat calcified coronary artery disease. Ali said his center was the first in the world to use the catheter in August 2025 and has since gained experience in roughly 80 cases.

“The Achilles' heel of IVL was its ability to deliver the catheter to get it into the lesions,” Ali explained. “It was considered to be a relatively inflexible device. Navigating tortuosity and getting it into calcified lesions was a challenge.”

The new Shockwave Medical catheter, however, dramatically improves flexibility and trackability, allowing operators to simplify procedures and reduce the need for additional support devices. Previous generations of IVL often required larger guide catheters, more supportive wires, buddy wires, guide extension catheters or femoral access to help advance the balloon across heavily calcified coronary lesions. Ali said this device largely eliminates those workflow adjustments.