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    Interventional procedure overview of intravascular lithotripsy to treat calcified coronary arteries during percutaneous coronary intervention

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    Indications and current treatment

    Coronary artery calcification (intimal and medial calcifications) increases the complexity of percutaneous treatment strategies in coronary interventions. It contributes to:

    • arterial wall stiffness

    • suboptimal stent delivery and expansion

    • in‑stent restenosis

    • high rates of stent thrombosis

    • the need for subsequent target lesion revascularisation after endovascular interventions.

    Standard endovascular treatment options for modifying calcium or plaque during PCI include balloon angioplasty using standard or high-pressure non-compliant balloons; cutting or scoring balloons; and stenting with or without coronary atherectomy (such as rotational, orbital or laser atherectomy). These treatments aim to allow optimal stent expansion and achieve maximal luminal gain. But they may sometimes lead to localised wall injury, balloon rupture or the risk of coronary vessel dissections or perforation. Intravascular lithotripsy is another endovascular treatment option for PCI.