In certain cases, marked calcifications of the coronary vessels cannot be dilated by a conventional balloon. In these situations, intravascular lithotripsy (IVL) and rotablation can be used. Targeted pretreatment of the calcified vessel can optimally prepare severely calcified vessels for subsequent stent implantation, which significantly improves long-term outcomes.
- Intravascular Lithotripsy (IVL): A special balloon is placed at the tip of the lithotripsy catheter. When the balloon is activated, shock waves are emitted in a controlled manner, similar to kidney stone disintegration. These shock waves specifically hit and shatter the calcium buildup in the vessels. Breaking up the vascular calcium allows a severely calcified vessel to be completely dilated and a stent to be implanted. With IVL, you also remain awake during the treatment, as the delivered shock waves do not cause any pain.
- Rotablation: A special catheter with a tiny diamond drill at its tip can be used to remove the calcification. Although the diamond drill can be surprisingly noisy, the treatment is painless. Once the calcium is removed, a balloon can be inserted and percutaneous transluminal coronary angioplasty can continue as usual.