Treatment of heavily calcified coronary artery stenosis using 3.5 mm peripheral intravascular lithotripsy balloon: case series

Karthik Mekala; Rajendra H Mehta; Mouhammed Joumaa; Hiroshi Yamasaki

doi:10.1093/ehjcr/ytaa211

Treatment of heavily calcified coronary artery stenosis using 3.5 mm peripheral intravascular lithotripsy balloon: case series

Eur Heart J Case Rep. 2020 Sep 10;4(5):1-5. doi: 10.1093/ehjcr/ytaa211. eCollection 2020 Oct.

Authors

Karthik Mekala¹, Rajendra H Mehta², Mouhammed Joumaa¹, Hiroshi Yamasaki¹

Affiliations

¹ Department of Cardiology, Ascension St. John Hospital, 22101 Moross Rd, Detroit, Michigan 48236, USA.
² Duke Clinical Research Institute, 200 Morris St., Durham, NC 27701, USA.

Abstract

Background: Prevalence of coronary artery calcification is high among patients with advanced age, chronic kidney disease, and diabetes. Percutaneous coronary intervention of heavily calcified coronary artery remains a significant challenge for interventional cardiologists. Although there are several modalities available in treating calcified coronary arteries, lesion preparation of certain heavily calcified vessels remains inadequate prior to stent deployment and/or often associated with worse periprocedural adverse outcomes.

Case summary: We report feasibility and safety of 3.5 mm peripheral intravascular lithotripsy (IVL) for the treatment of severely calcified coronary stenosis in two patients after orbital atherectomy failed to debulk calcified plaque to enable stent deployment.

Discussion: Intravascular lithotripsy has recently emerged as a therapeutic option in treating calcified peripheral artery disease. However, coronary IVL is currently available only in a few centres in the USA. Studies are ongoing in the safety and efficacy of this technology in treating coronaries.

Keywords: Atherectomy; Case series; Coronary artery disease; Intravascular ultrasound.