Intravascular Shockwave Lithotripsy: An Adjunct to Balloon Angioplasty for Calcified Pulmonary Vein Stenosis

Pulmonary vein stenosis occurs in 0.4% to 2% of cases after atrial fibrillation ablation. Patients experience chest pain or shortness of breath when pulmonary vein narrowing exceeds 60% or its diameter falls below 4 to 6 mm. To our knowledge, this is the first case report of the use of shockwave intravascular lithotripsy to address calcified pulmonary vein stenosis after the conventional approach of balloon angioplasty failed to result in expansion. Our case highlights that shockwave intravascular lithotripsy is a feasible, safe, and effective adjunctive therapy for treating calcified pulmonary vein stenosis.