Cardiovascular disease including coronary artery disease is the leading cause of death in adults. The coronary arteries are the arteries that supply blood and oxygen to the heart. At Physicians Regional Healthcare System narrowing of the coronary arteries can be treated with open heart surgery (bypass surgery), angioplasty, stenting, and atherectomy.
Coronary shock wave lithotripsy is a new treatment for calcified blockages that is available at Physicians Regional. Heavily calcified narrowing of the coronary arteries is commonly seen. These calcified blockages of the coronary arteries are difficult to treat. They frequently do not expand with balloon angioplasty even when the balloon is inflated to very high pressures. Coronary lithotripsy is now FDA approved for the treatment of calcified coronary arteries. It is performed prior to stenting in the cardiac catheterization suite.
Coronary lithotripsy was approved based on four studies (the Disrupt CAD studies). These studies included a total of 628 patients and showed a high success rate – 92.4%, and a low complication rate – 2.1%. It is performed using a special balloon catheter which is positioned in a coronary artery at the site of a calcified blockage. Inside the balloon catheter is an emitter. The emitter releases electrical discharges that generates a sonic pressure wave inside the artery. The sonic pressure wave breaks up calcium in the wall of the artery. This facilitates expansion of the vessel with balloon inflations at low pressure and allows full stent expansion.
Coronary shockwave lithotripsy is performed through an IV by interventional cardiologists at Physicians Regional Healthcare System at the time of cardiac catheterization.
Dr. Joseph Califano M.D., Interventional Cardiologist, recently encountered a 71 year old male who suffered a heart attack from a complete blockage in the right coronary artery. The right coronary was treated with emergency balloon angioplasty and stenting with an excellent result.
“At the time of his heart attack we also found blockage in his left anterior descending and diagonal arteries,” Dr. Califano explains, “Therefore he was brought back to the cardiac catheterization laboratory at Physicians Regional two days after his heart attack for treatment of these blockages which are shown in photo 1.”
A balloon was inflated to 20 times atmospheric pressure when treating the patient’s blockages. Despite this, the vessels remained severely narrowed and the calcium in the artery prevented the balloon from expanding, as seen in photo 2. Because of this, Dr. Califano then treated both the left anterior descending and the diagonal branch with shockwave lithotripsy.
After coronary lithotripsy both the left anterior descending and the diagonal artery expanded with low pressure balloon inflations. Full stent expansion was achieved with an excellent result in both vessels. (Photos 3 and 4)
The final picture after stenting shows both the main vessels and side branches wide open. In this patient the entire procedure was performed through an IV in his wrist and he was discharged that evening. He has made a full recovery and has resumed all activity including exercise.
Dr. Califano is located at our Pine Ridge Campus – 6101 Pine Ridge Rd., Naples FL, 34119. To schedule an appointment with one of our cardiologists, please call 855-85-GREAT (855-854-7328) or visit physiciansregional.com/find-a-doctor.