Tag Archives: intravascular lithotripsy

Case 1 – off-label use A 57-year-old man was referred to the chest pain clinic for further investigation with complaints of progressive dyspnoea on minimal exertion, consistent with New York Heart Association (NYHA) class 3 symptoms. His past medical history included hypertension, hypercholesterolaemia, ischaemic heart disease (ST-elevation myocardial infarction in 2003 requiring percutaneous coronary intervention [PCI] to the distal right coronary artery [RCA]) and a high body mass index (BMI). On examination his vital signs were normal and there were no significant clinical findings. He underwent an electrocardiogram (ECG), routine blood

Introduction The evolution of modern percutaneous coronary intervention (PCI), with miniaturisation of technology, improved device delivery and ancillary devices available to facilitate completion of complex cases, has opened the doors of the catheterisation laboratory to both elderly patients with complex coronary anatomy, as well as those with multiple comorbidities that might have otherwise historically been considered unfit for coronary intervention. As a direct result of this, cardiologists are increasingly treating highly calcified, severely obstructed and chronically occluded coronary vessels.1 Highly calcified vessels are considerably