In some instances, the coronary narrowing can be particularly hard related to calcification of the furrings (atheroma) within the coronary artery. This may preclude the balloon to adequately expand to facilitate stent implantation. This is particularly important because in the absence of adequate expansion (or stretching) of the artery, stents have a higher risk of re-narrowing or blocking.
In this situation, Prof Ruparelia may suggest intravascular lithotripsy (Shockwave) therapy. This is a novel procedure that is designed to deliver localised pulsatile sonic pressure waves, modifying calcified lesions. This will then enable adequate expansion of balloons and stents to facilitate optimal stent results.
The treatment is painless and Prof Ruparelia shall explain the risks and benefits associated with this intervention.