Abstract
Key points Agents which dissolve hydroxyapatite may synergize with intravascular lithotripsy (IVL) to treat calcium plates more extensively, facilitating greater penetration of drug‐coated balloons delivered agents and maintain gain in lumen area without stenting. Dissolving hydroxyapatite could potentially allow more frequent use of high‐pressure balloons without IVL or atherectomy to fracture calcium plates, offering a lower cost approach. Other mechanisms such as debonding between calcium plate and fibrous tissue junctions may also be enhanced with IVL and calcium‐modifying agents to improve calcified vessel compliance.
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