Shockwave intravascular lithotripsy

1. Indication: CSL is used for patients with significant coronary artery calcification that makes conventional treatments like balloon angioplasty and stenting difficult. These calcified plaques can make it hard to expand the artery and properly place a stent.

2. Procedure:

   • Preparation: Patients are typically given antiplatelet medications before the procedure. They may also receive sedatives to help them relax.
   • Access: A catheter is inserted into the patient's artery, usually through the groin or wrist, and guided to the site of the calcified blockage in the coronary artery.
   • Balloon Catheter: A special balloon catheter with integrated lithotripsy emitters is positioned at the site of the calcification.
   • Shockwave Emission: Once in place, the balloon is inflated, and controlled sonic pressure waves are emitted. These shockwaves fracture the calcified plaque, making it easier to expand the artery and place a stent.
   • Stenting: After the calcified plaque is broken up, a stent is placed to keep the artery open and maintain proper blood flow.

3. Benefits:

   • Effectiveness: CSL can effectively treat heavily calcified coronary lesions that are resistant to other forms of intervention.
   • Minimally Invasive: The procedure is less invasive compared to traditional open-heart surgeries.
   • Reduced Complications: By addressing the calcification directly, CSL can reduce the risk of complications associated with stent placement in calcified arteries.

4. Recovery: Recovery from CSL is similar to other coronary catheterization procedures. Patients are usually monitored for a few hours post-procedure and may be required to stay overnight in the hospital.

5. Risks: As with any medical procedure, CSL carries risks such as bleeding, infection, or artery damage. However, it is generally considered safe and effective for patients with complex coronary artery disease.

Coronary shockwave lithotripsy represents a significant advancement in the treatment of coronary artery disease, particularly for patients with severe arterial calcification.