Vascular: AVS Pulse CTO Robert Chisena on Intravascular Lithotripsy and the Future of Calcium Treatment

Calcified arteries remain one of the toughest challenges in cardiology and peripheral vascular care. Robert Chisena, CTO and co-founder of AVS Pulse Technologies, explains how their intravascular lithotripsy platform uses pulsatile CO₂ energy to fracture calcium safely and effectively.

We cover how AVS Pulse differentiates from competitors, the “smart” IVL feedback system, and why this space has become one of the hottest in medtech after multibillion-dollar acquisitions.

Episode Breakdown

00:00 – Why calcified arterial disease is such a challenge

01:22 – Meet Robert Chisena, CTO and co-founder of AVS Pulse Technologies

02:01 – How calcium buildup blocks blood flow and leads to serious outcomes

03:07 – Why existing technologies struggle with calcium treatment

04:42 – AVS Pulse origins at the University of Michigan

05:34 – Finding the “chinks in the armor” of calcium

06:27 – How pulsatile CO₂ energy fractures calcium

07:38 – The water hammer effect explained

08:37 – Comparing AVS Pulse to existing lithotripsy devices

09:47 – Differentiators: low profile, flexibility, energy efficiency

11:14 – 5000 pulses vs rationing with other catheters

13:12 – Clinical studies show fast, safe outcomes in complex lesions

13:45 – First “smart” IVL device with intra-procedural feedback

14:54 – Regulatory pathway and pivotal trials in peripheral and coronary indications

17:02 – Promising first-in-human PAD I study results

19:07 – How energy delivery reduces dissections compared to other methods

21:24 – What happens to calcium once fractured

22:01 – Positioning IVL as a prep tool for stenting

23:32 – Differentiating IVL from thrombectomy and other treatments

23:38 – Funding raised and milestones ahead

24:45 – Timeline for commercial launch and next clinical trials

25:02 – Upcoming conferences: TCT and VIVA presentations

26:08 – Why the market is heating up and where AVS Pulse fits in

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