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Treatment of Heavily Calcified Unprotected Left Main Disease With Lithotripsy: The First Case Series
Bernard Wong1, Seif El-Jack, Ali Khan
1North Shore Hospital, 124 Shakespeare Road, Takapuna, Auckland 0620, New Zealand. bernardwong@hotmail.co.nz.
Insights
This study introduces Shockwave Intravascular Lithotripsy (S-IVL) for treating complex left main coronary artery disease. S-IVL offers a new percutaneous option for heavily calcified lesions where surgery is not feasible.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Devices
Background:
- Unprotected left main coronary artery disease (LM-CAD) poses significant revascularization challenges.
- Treatment decisions for LM-CAD involve balancing anatomical complexity and surgical risk.
- Heavily calcified LM-CAD often complicates percutaneous coronary intervention (PCI).
Abstract:
We present the first case series using Shockwave Intravascular Lithotripsy (S-IVL; Shockwave Medical), a novel coronary calcium modification device, in patients with heavily calcified unprotected left main (LM) coronary artery disease (CAD). Decisions regarding surgical vs percutaneous revascularization in LM-CAD patients are based on anatomical complexity and perceived surgical risk. In this series, we present the use of S-IVL in a patient with LM-CAD with multivessel disease who declined surgery, a patient with an isolated LM-CAD and severe cardiomyopathy, and a late nonagenarian patient where surgical revascularization was not an option.
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