Calcification of coronary artery plaques poses unique challenges in treatment with angioplasty and stent. Hard calcified blockages do not yield easily to balloon and therefore the stent doesn’t expand well. This effect long term outcomes of angioplasty. Various methods have been hitherto available to deal with this situation, such as rotablation , very high pressure balloons , atherectomy devices etc. A very recent addition to the armamentarium is Shockwave lithotripsy also called intravascular lithotripsy, which uses a special balloon to deliver high pressure waves at the blockage and breaks the calcium. This softens the blockage and facilitates successful angioplasty and stenting.
Sakra World Hospital, one of the city’s leading multispecialty hospital, performed Karnataka’s first Coronary Shockwave Lithotripsy surgery recently. This surgery was carried out by Dr Sreekanth B Shetty, Senior Consultant and Head of Interventional Cardiology, Sakra World Hospital on a 75-year-old patient suffering from an advanced form of Coronary Artery Disease (CAD) with multiple blockages which turn hard due to calcification.
The patient came with a resistant heart failure and had multiple artery blockages with calcium deposits along with other underlying health conditions because of which he could not undergo bypass surgery. He was treated with a combination of Rotablation and Shockwave lithotripsy.This innovative technology was launched by Shockwave Medical, USA, and was introduced in India only a few weeks ago after being approved by the Drug Controller General of India (DCGI).
Commenting on the procedure and the technology, Dr Sreekanth B Shetty says, “Sakra World Hospital has always been the forefront of adopting new technology and provide world-class clinical medical services to its patients. We are glad to be the first hospital in Karnataka to conduct Shockwave Intravascular Lithotripsy. This innovation will benefit numerous patients undergoing angioplasties. Over time, coronary blockage becomes hard which leads to deposition of calcium. Often these blockages do not let the conventional balloons to dilate the lesion leading to unsatisfactory results in angioplasties performed. Also, under expanded stents carry high risks such as stent clot formation which causes a 30-40% mortality rate and also of restenosis. However, with this novel technology, we can easily open up calcified plaques safely in carefully selected cases.”