ELCA-Tripsy: Combination of Laser and Lithotripsy for Severely Calcified Lesions

Rotational atherectomy (RA) and intravascular lithotripsy (IVL) are complementary calcium-debulking techniques. RA ablates intimal calcium and makes a channel that permits crossing of the Shockwave balloon, which cannot be easily delivered through severe lesions. Shockwave IVL completes lesion preparation, cracking deep calcium. When RA is discouraged, excimer-laser coronary angioplasty (ELCA) in combination with IVL (ELCA-Tripsy) may be useful, as ELCA facilitates Shockwave balloon delivery without impairment of recently implanted stents. To the best of our knowledge, this is the first description of this technique.