Shockwave (IVL) for Safe Treatment of Heavily Calcified Lesions
One of the treatments for ischemic heart diseases such as angina pectoris is percutaneous coronary intervention (catheter treatment). Catheter treatment generally involves using balloons and stents to widen areas of the coronary artery that have narrowed due to atherosclerosis, thereby restoring blood flow.
Atherosclerosis includes soft parts such as cholesterol deposits, as well as calcification, where calcium accumulates and hardens the vessel walls. In heavily calcified and hardened lesions, conventional catheter treatments (balloons and stents) alone may not adequately widen the blood vessel. If a stent is placed without sufficiently widening the vessel, the treated area may narrow again or suddenly become blocked, potentially causing a heart attack.
Previously, for heavily calcified lesions, treatments like rotablation or diamondback were used, which are similar to dental drills that grind away the calcium. However, these treatments posed risks of damaging the blood vessel with the drill and causing complications where fine particles could obstruct downstream blood flow, requiring relatively advanced technical skills. Recently, a new treatment device called the Shockwave catheter has been developed to safely treat such heavily calcified lesions.
Unlike conventional treatments that grind calcium, the Shockwave catheter enables treatment of calcified lesions using a unique principle. A balloon that emits shockwaves (sonic pressure waves) creates numerous fine cracks in the calcium, softening heavily calcified lesions. After using this device, the blood vessel can be adequately widened with a conventional balloon, significantly shortening treatment time. Moreover, these shockwaves do not damage normal soft tissue or cause fine particles to flow downstream, greatly reducing the risks associated with previous treatments. The Shockwave catheter is expected to enable safe and appropriate treatment for lesions that were previously difficult to treat. However, there may still be cases where treatment using a rotablator to grind calcium is more appropriate.
Our hospital introduced the Shockwave catheter in December 2023. Before catheter treatment, our team thoroughly discusses and considers treatment methods, and during treatment, we select the most appropriate treatment device while referring to intravascular imaging and other data.
For those who want to know more about the process of cardiac catheterization and treatment at our hospital, please refer to here.
