Modified leopard-crawl technique using intravascular lithotripsy balloon in calcified coronary lesions

Catheter Cardiovasc Interv. 2023 Nov;102(6):1066-1068. doi: 10.1002/ccd.30893. Epub 2023 Oct 19.


Intravascular lithotripsy (IVL) has emerged as a novel therapy for the treatment of coronary calcification. Numerous studies have reported the safety and efficacy of IVL in calcified coronary lesions, while IVL balloon-uncrossable calcified coronary lesions are sometimes encountered in clinical practice. This case report represents a novel technique called "modified leopard-crawl" to advance the IVL balloon antegradely by creating significant calcium cracking forward when the enhanced stent visualization system reveals that the distal emitter seems adjacent to calcification. This technique might be a valuable alternative when conventional procedures fail and has the potential to enhance the clinical applicability of IVL in daily practice.

Keywords: IVUS; OCT; PCI; coronary calcification; intravascular lithotripsy.

Publication types

  • Case Reports

MeSH terms

  • Calcinosis* / diagnostic imaging
  • Calcinosis* / therapy
  • Calcium
  • Humans
  • Lithotripsy*
  • Treatment Outcome
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / therapy


  • Calcium