Smart solution for hard times: successful lithoplasty of an undilatable lesion

After unsuccessful percutaneous coronary interventions (PCI) with high-pressure balloons (40？atm) and rotational atherectomy (1.5？mm burr), a 70-year-old woman was re-admitted for lithoplasty-assisted PCI. Lithoplasty balloons (Shockwave Medical, Freemont, California) were developed based on the principles of kidney stone treatment. With an array of emitters they generate pulsatile, circumferential sonic pressure waves to selectively disrupt intimal and medial calcifications, usually resulting in calcium tears and focal dissections [1, 2]