Intravascular Lithotripsy Catheter Advances Treatment of Calcified Coronary Disease

Calcified coronary artery disease complicates revascularization by impeding device deliverability and lesion crossing, particularly in tortuous vessels. Coronary artery disease is the leading cause of death worldwide and affects an estimated 315 million people, including about 1 in 20 U.S. adults over 20. Clinicians need tools that can efficiently modify calcium while preserving control within complex anatomy. A newly launched device now extends intravascular lithotripsy with improved deliverability, lesion crossing, and balloon repositioning.

Johnson & Johnson has introduced the Shockwave C2 Aero Coronary IVL Catheter, a next-generation intravascular lithotripsy (IVL) catheter designed to enhance deliverability, facilitate lesion crossing, and enable balloon repositioning for calcified coronary artery disease. The system leverages the clinically validated IVL mechanism of action used in the company’s legacy catheters while broadening its IVL portfolio for more complex lesions. It is intended to provide added flexibility and efficiency in challenging anatomy without reliance on additional upfront ancillary devices.

Shockwave C2 Aero employs a 138-centimeter working-length catheter with two emitters encased in an integrated balloon that activate simultaneously, delivering up to 120 pulses and a total of up to 240 shockwaves. Each pulse generates ultrasonic acoustic pressure waves that pass through soft tissue to crack hardened calcium in place, helping re-establish coronary blood flow. 

To support deliverability through tight, tortuous vessels, the catheter incorporates a more flexible shaft, balloon, and marker bands. A tapered tip with a new hydrophilic coating is designed to ease entry and crossing of dense calcified deposits, while a new balloon material enables more compact deflation to facilitate repositioning and treatment of additional lesions.

Design enhancements in deliverability are compared to the prior-generation Shockwave C2+ in simulated-use bench testing, and feature refinements reflect feedback from physicians who participated in a limited market release survey. Shockwave C2 Aero is now available in the United States and Japan, with availability in Europe and Canada expected in the coming months. The technology will be showcased at EuroPCR 2026 in Paris, France, from May 19–22, 2026.