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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Related Experiment Video

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The Coronary Intravascular Lithotripsy System.

Maria Natalia Tovar Forero1, Joost Daemen1

  • 1Thoraxcenter, Erasmus University Medical Center Rotterdam, the Netherlands.

Interventional Cardiology (London, England)
|December 24, 2019
PubMed
Summary

Coronary intravascular lithotripsy offers a novel approach to treating calcified lesions, improving percutaneous intervention outcomes. This therapy uses pulsatile mechanical energy to safely fracture calcium, reducing complications and enhancing stent deployment.

Keywords:
Shockwave Intravascular Lithotripsy Systemcoronary calcificationcoronary lithotripsycoronary plaque modification

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Area of Science:

  • Cardiovascular Interventions
  • Medical Device Technology
  • Interventional Cardiology

Background:

  • Calcified lesions complicate percutaneous coronary interventions, leading to suboptimal results and increased procedural risks.
  • Current plaque modification devices primarily use compression or debulking, with variable success in calcium fracture.
  • Significant unmet need exists for safe and effective calcium modification to improve stent implantation.

Purpose of the Study:

  • To review the current evidence for coronary intravascular lithotripsy (IVL) in treating calcified coronary lesions.
  • To describe the mechanism of action, components, and function of the Shockwave Intravascular Lithotripsy System.
  • To evaluate the safety and efficacy of IVL as a plaque modification technique.

Main Methods:

  • Systematic review of existing clinical studies and literature on coronary IVL.
  • Description of the Shockwave IVL System, including its emitter, catheter, and energy delivery system.
  • Analysis of procedural outcomes, complications, and long-term adverse events associated with IVL therapy.

Main Results:

  • Coronary IVL demonstrates a favorable safety profile with low rates of procedural complications.
  • The therapy effectively fractures calcium, facilitating optimal stent expansion and apposition.
  • Evidence suggests improved clinical outcomes and reduced need for repeat interventions in patients treated with IVL.

Conclusions:

  • Coronary intravascular lithotripsy is a safe and effective modality for modifying calcified coronary lesions.
  • IVL offers a distinct mechanism of action, delivering pulsatile mechanical energy to disrupt calcium.
  • This therapy represents a significant advancement in interventional cardiology for managing complex coronary artery disease.