Efficacy of shockwave C2 coronary intravascular lithotripsy for management of severely calcified left anterior descending stenosis

Abstract

Severely calcified coronary lesions remain a formidable hurdle for percutaneous coronary intervention as it averts the stent delivery and complete stent apposition. To overcome this Achilles heel of an interventional cardiology, a current US FDA approved method named shockwave intravascular lithotripsy (S-IVL; Shockwave Medical, Inc) is used for its treatment. Herein, we report a case of a 53-year-old dyslipidemic male with severely calcified left anterior descending artery (LAD) lesion that was successfully treated with S-IVL and drug-eluting stent implantation. At first, the patient was presented with complaints of chest pain and breathlessness. His coronary angiogram revealed heavily calcified stenosis in diffuse mid LAD—completely totally occluded mid-diagonal (D) 1 that was checked through retrograde filling via collateral and calcified stenosis in ostial D2, mild stenosis in ostial left circumflex and mild stenosis at distal before crux 50% stenosis in dominant right coronary artery. Following this, it was decided to proceed with primary percutaneous coronary intervention with S-IVL to LAD. After successful delivery of S-IVL to LAD, a Tetriflex sirolimus eluting stent (Sahajanand Medical Technologies Ltd., Surat, India) was successfully implanted at LAD. Finally, the patient’s condition was stabilized and discharged after two days of index procedure.