A 76-year-old patient who was suffering from hypertension and diabetes for 30 years got treated by Dr. Nitin Tiwari, Senior Consultant- Cardiology. He was advised of bypass surgery and was not ready for the same. Hence Dr Tiwari advised him on Angioplasty with help of IVL (Intravascular lithotripsy).
According to Dr Nitin Tiwari, “This is a path-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. This will bring hope for many patients whose arteries could not be opened by balloon angioplasty because of calcium build up and were considered for Bypass Surgeries or left on medical management.”
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.
Shockwave Intravascular Lithotripsy is a novel procedure which brings hope for those suffering from an advanced form of coronary artery disease (CAD) having angina or heart attack in which the blockage becomes very hard due to deposit of calcium.
This happens in 20% to 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, cutting balloons etc which are difficult to use and carry risk of rupturing the artery.
Intravascular Lithotripsy launched by Shockwave Medical, USA is an innovative technology that generates sonic pressure waves to break up problematic calcium so that 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 blockage is 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 result for long term.
The sonic pressure waves are produced when performing intravascular Lithotripsy which gives a novel, safe and proven treatment option to break the calcified plaque with potentially less risk of injury to the artery compared to other treatment.
While it is slow to develop, its impact is immediately encountered when performing procedures in calcified lesions. The calcium's hardened structure restricts normal 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.