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As new calcium-modifying technologies expand the repertoire of below-the-knee (BTK) arterial disease interventions, how should your treatment algorithm evolve, and what endpoints matter most? In this episode of the BackTable Podcast, Dr. Constantino Peña of the Baptist Health Miami Cardiac and Vascular Institute joins Dr. Sabeen Dhand to discuss the latest advancements in BTK chronic limb-threatening ischemia (CLTI) therapies and the push to improve on current vessel preparation outcomes. --- This podcast is supported by: Shockwave Medical https://shockwavemedical.com/ --- SYNPOSIS The physicians discuss the evolution of tibial arterial therapies, the challenges presented by heavily calcified lesions, and the impact of new tools, particularly the Shockwave E8 intravascular lithotripsy (IVL) device, on procedural considerations and endpoints. Dr. Peña shares his treatment algorithms and offers practical advice on selecting the right tools for each unique case. The episode closes with speculation on the future of treatment options and technologies for BTK disease, and the growing need for robust data to guide patient-specific treatment. --- TIMESTAMPS 00:00 - Introduction 02:11 - Understanding Tibial Disease and Treatment Evolution 07:22 - Advancements in Tibial Disease Treatment and the Role of IVL 15:31 - Techniques for Effective IVL Sizing and Usage 21:28 - Challenges and Innovations in Tibial Disease Management 26:48 - Innovations in Stent Technology 30:43 - Combining IVL with Adjunct Therapies 32:13 - Addressing Misconceptions in Tibial Treatment 37:54 - Advancements in Intravascular Lithotripsy 40:59 - Future of Vascular Treatments 43:42 - Final Thoughts --- The BackTable Podcast is a resource for interventional radiologists, vascular surgeons, interventional cardiologists, and other interventional and endovascular specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Get notified when new episodes drop! Subscribe to the BackTable Podcast on your go-to podcast platform, and follow us on your social media platform of choice for regular vascular and interventional updates. ► https://www.backtable.com/shows/vi/su... #VI615 #ischemia #angioplasty #limbsalvage