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Shock Wave Intravascular Lithotripsy (IVL)-Assisted Staged Percutaneous Coronary Intervention (PCI) for a Calcified

Sanjay Kumar Sharma1

  • 1Department of Cardiology, Neo Hospital, Noida, IND.

Cureus
|June 2, 2022
PubMed

Insights

This case report highlights the successful use of shockwave intravascular lithotripsy (IVL) for managing complex coronary artery calcification in India. IVL-assisted percutaneous coronary intervention (PCI) effectively treated severe right coronary artery stenosis.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Coronary artery calcification poses significant challenges during percutaneous coronary intervention (PCI).
  • Shockwave intravascular lithotripsy (IVL) has emerged as a valuable tool for treating calcified coronary lesions.
  • There is limited published data on IVL use in the Indian population.

Observation:

  • A 74-year-old male presented with ST-segment elevation myocardial infarction (STEMI).
  • Coronary angiography revealed thrombotic occlusion in the left anterior descending artery (LAD) and calcific stenosis in the right coronary artery (RCA).
  • The patient underwent immediate PCI for LAD and a staged PCI for RCA due to unstable angina.

Findings:

  • The staged PCI of the RCA was successfully performed with shockwave IVL assistance.
  • The procedure effectively managed the severe calcific stenosis in the RCA.
  • Post-intervention, the patient showed improved thrombolysis in myocardial infarction (TIMI) flow.

Implications:

  • This case demonstrates the feasibility and efficacy of shockwave IVL in managing complex coronary artery calcification in an Indian patient.
  • It supports the use of IVL as a treatment option for challenging calcified lesions in this demographic.
  • Further studies are warranted to establish IVL's role in the Indian interventional cardiology landscape.

Keywords:
calcificationslithotripsypercutaneous coronary interventionright coronary arterysingle-vessel disease

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