Calcified blockage happens in 20% - 25% of the patients, especially those who are elderly, diabetic have chronic kidney disease, have long-standing blockages, or previous bypass surgery. Previously to tackle this heavily calcified blockage, there were only drills called Rotablator or ultra-high pressure balloons, which are difficult to use and carry the risk of rupturing the artery.
‘Shockwave Intravascular Lithotripsy is a novel procedure that helps people suffering from an advanced form of coronary artery disease (CAD) having angina or heart attack in which the blockage becomes very hard due to the deposit of calcium. ’
Intravascular lithotripsy launched by Shockwave Medical, USA, is an innovative technology that generates sonic pressure waves to break up problematic calcium so that the artery can be opened with ease and blood flow restored with the placement of a stent. The therapy leverages a similar minimally invasive approach that has been embraced by physicians for decades to treat kidney stones, which are also made up of calcium.
"Hardened calcified blockages are a big challenge to treat by angioplasty and stents and is getting commoner. Such blockages can now be opened with ease and safety to give patients the best results for the long term. The sonic pressure waves produced when performing Intravascular Lithotripsy gives us a novel, safe and proven treatment option to break up the calcified plaque, with potentially less risk of injury to the artery compared to other.
Hospital, London, who has the highest experience with this therapy in the breaking therapy, which is revolutionizing the treatment of hard plaque in Coronary arteries world over, and I am glad that this is now available in India to patients in India.
Calcium slowly develops and progresses to its hardened, bone-like state over the course of several decades of cellular growth and death in diseased plaque within the heart arteries. While it is slow to develop, its impact is immediately encountered when performing procedures in artery movement and makes the rigid arterial tissue resistant to traditional balloon therapies that have been designed to compress the plaque within the artery wall to restore normal blood flow. For these reasons, the presence of calcium increases the complexity of most cases and decreases the effectiveness of most treatments.
How Intravascular Lithotripsy (IVL) Works?
Intravascular lithotripsy uses a small generator to produce therapeutic sonic pressure waves from a catheter that is threaded through the arterial system to the site of the blockage. The pressure waves pass through the soft vascular tissue, preferentially disrupting the hardened calcified plaque inside the arterial wall by creating a series of micro-fractures. After the calcium has been modified, the artery can be expanded using a low-pressure balloon and a stent, thereby enabling even historically challenging CAD patients to be treated effectively with minimal injury to the vessel.