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Sciahbasi et al. Vessel Plus 2023;7:19 Vessel Plus
DOI: 10.20517/2574-1209.2023.22

Review Open Access

Crack the rock: the role of coronary lithotripsy for

heavy calcified lesions

Alessandro Sciahbasi 1 , Simona Minardi 2
1
Department of Interventional Cardiology, Sandro Pertini Hospital, Rome 00157, Italy.
2
Cardiology, Department of Health, Life, and Environmental Sciences, University of L'Aquila, L’Aquila 67100, Italy.
Correspondence to: Dr. Alessandro Sciahbasi, Department of Interventional Cardiology, Sandro Pertini Hospital, ASL Roma 2,
Rome 00157, Italy. E-mail: asciahbasi@gmail.com

How to cite this article: Sciahbasi A, Minardi S. Crack the rock: the role of coronary lithotripsy for heavy calcified lesions. Vessel
Plus 2023;7:19. https://dx.doi.org/10.20517/2574-1209.2023.22

Received: 6 Apr 2023 First Decision: 28 Jul 2023 Revised: 7 Aug 2023 Accepted: 4 Sep 2023 Published: 7 Sep 2023

Academic Editor: Giuseppe Ando Copy Editor: Fangling Lan Production Editor: Fangling Lan

Abstract
Since the first balloon angioplasty 40 years ago, percutaneous coronary interventions (PCI) applicability continues
to expand, even in the context of complex coronary anatomies, previously considered unsuitable for PCI. A very
challenging scenario for PCI is the treatment of heavily calcified coronary stenosis that is associated with early
complications and late adverse events. Countless tools and techniques have been introduced to treat calcified
coronary stenosis, and among these, a new and promising technique obtained from lithotripsy technology
employed for the treatment of uretero-renal calculi has been introduced: the intravascular lithotripsy (IVL). IVL
utilizes acoustic shockwaves in a balloon-based delivery system that induces calcium fractures, facilitating stent
advancement and expansion. This review aims to describe the device used for IVL, the results of clinical studies
published, and the possible clinical use.

Keywords: Intracoronary lithotripsy, PCI, stent

INTRODUCTION
[1]
Percutaneous coronary intervention (PCI), first introduced in 1977 by Andreas Grüntzig , has substantially
evolved over the past 40 years and its applicability continues to expand, even in the context of some
[2]
complex coronary anatomies, previously considered unsuitable for PCI . With an aging society, more and
more frequently, interventional cardiologists are facing complex coronary lesions that include bifurcations,

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
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