Shockwave Coronary Lithoplasty for the Treatment of Under-Expanded Stent

The presence of coronary calcification is a hard challenge for the interventional cardiologist, as it is associated with incomplete stent expansion and frequently stent failure.In recent years, innovative techniques have been developed to treat coronary calcific lesions such as rotational atherectomy.However, many of them are burdened with an increased procedural risk.Recently, a new technique called "Shockwave Coronary Lithoplasty System", also called lithotripsy, has been introduced in order to treat calcific coronary lesions with greater safety.Shockwave procedure allows treating the most calcific coronary lesions with simplicity and safety.This system employs the sound waves, similar to that used for treating kidney stones, in order to crush the calcific lesions.In this minireview, we explain the characteristics of the method and we provide a description of the technique in detail on the basis of the preliminary experience of the first cases.In particular, we will demonstrate that this technique is more effective and safer than traditional techniques employing atherectomy, also providing for the first time a therapeutic chance for the treatment of under-expanded stents in many clinical contexts.