Smart solution for hard times: successful lithoplasty of an undilatable lesion

• DOI: 10.1007/s12471-019-1261-2
• Publication Date: 2019-03-13T13:13:25Z
• Authors: J. Vainer; A. Lux; M. Ilhan; R. A. L. J. Theun...; S. Aydin; A. W. J. van ’t Hof
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Heart Beat

After unsuccessful percutaneous coronary interventions (PCI) with high-pressure balloons (40 atm) and rotational atherectomy (1.5 mm burr), a 70-year-old woman was re-admitted for lithoplasty-assisted PCI.Lithoplasty (Shockwave Medical, Freemont, California) were developed based on the principles of kidney stone treatment.With an array emitters they generate pulsatile, circumferential sonic pressure waves to selectively disrupt intimal medial calcifications, usually resulting in calcium tears focal dissections [1,2].In this patient Canadian Cardiovascular Society Class II angina, 6 Fr compatible device effectively modified extremely resistant lesion (Fig. 1a).Optical coherence tomography (OCT) showed typical large dissection 1b; [2][3][4]).To cover lesion, drug-eluting stent (4.5 mm) implanted post-dilated non-compliant balloon.Proper expansion apposition confirmed OCT.