Abstract

Coronary calcium is a problem for interventional cardiologists everywhere since it frequently results in stent under-expansion and ischemic events. Although aggressive balloon post-dilatation is often insufficient, several plaque ablation techniques are widely used despite being technically tricky and problematic. Shockwave intravascular lithotripsy (S-IVL), which has a high safety margin, has gained popularity for controlling calcium during percutaneous coronary intervention (PCI). We also believe these techniques are complementary. However, Evidence is lacking regarding the modification of calcified plaques by ELCA. There aren't many published case reports about using intravascular lithotripsy (IVL) with Excimer laser coronary angioplasty (ELCA) during PCI. Here, we describe a case of effectively treated calcified left anterior descending artery (LAD) using shock wave IVL and ELCA assistance. In this case study, we present a 72-year-old male with a history of hypertension, diabetes mellitus type 2. The use of ELCA and Intravascular Lithotripsy (IVL) in this case successfully addressed the heavily calcified lesion in the proximal LAD artery, allowing for optimal stent placement. In calcified lesions that are uncrossable, ELCA should be the strategy of choice, used in combination with other techniques.