Abstract
In severely calcified lesions, the intravascular lithotripsy (IVL) can be an effective therapy for preparation of the lesion so that drug eluting stent (DES) can be deployed optimally, and the future events of stent failure can be minimized. From the recent studies with IVL we can certainly say it is a novel therapy. The mechanism as depicted by optical coherence tomography (OCT) is found to be calcium fractures induced by shockwaves. The above said modification is done with minimal complications of perforation, no reflow, low incident of flow limiting dissection and myocardial infarctions. The other methods like cutting or scoring balloons, rotational atherectomy have also shown to improve luminal diameter, but other complications like distal embolization is a challenge of concern. This review reports a single centre study to all comer patients even with complex characteristics. This therapy was found to be very effective and with minimal complications. In this article we describe the mechanism of action, about IVL catheter, its OCT validation, clinical uses, its comparison with other calcium modifying technologies and what other future directions can be utilized to improve the technology and can it be used in all comers with calcified coronaries.
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