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12-03-2019 | Heart Beat | Uitgave 4/2019 Open Access

Netherlands Heart Journal 4/2019

Smart solution for hard times: successful lithoplasty of an undilatable lesion

Netherlands Heart Journal > Uitgave 4/2019
J. Vainer, A. Lux, M. Ilhan, R. A. L. J. Theunissen, S. Aydin, A. W. J. van ’t Hof
After unsuccessful percutaneous coronary interventions (PCI) with high-pressure balloons (40 atm) and rotational atherectomy (1.5 mm burr), a 70-year-old woman was re-admitted for lithoplasty-assisted PCI. Lithoplasty balloons (Shockwave Medical, Freemont, California) were developed based on the principles of kidney stone treatment. With an array of emitters they generate pulsatile, circumferential sonic pressure waves to selectively disrupt intimal and medial calcifications, usually resulting in calcium tears and focal dissections [ 1, 2].
In this patient with Canadian Cardiovascular Society Class II angina, the 6 Fr compatible device effectively modified the extremely resistant lesion (Fig.  1a). Optical coherence tomography (OCT) showed typical calcium tears and a large dissection (Fig.  1b; [ 24]). To cover the lesion, a drug-eluting stent (4.5 mm) was implanted and post-dilated with a non-compliant balloon. Proper stent expansion and apposition were confirmed with OCT.
In conclusion, lithoplasty may become an essential and safe plaque modification tool, especially in coronary arteries with large inner diameters and subintimal calcifications [ 2].

Conflict of interest

J. Vainer, A. Lux, M. Ilhan, R.A.L.J. Theunissen, S. Aydin and A.W.J. van ’t Hof declare that they have no competing interests.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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