Heart specialists at Virtua Our Lady of Lourdes Hospital in Camden became the first in South Jersey to perform Shockwave intravascular lithotripsy, a new, life-saving procedure.
Virtua Health interventional cardiologist Dr. John Finley said the treatment opens clogged heart arteries that are especially difficult to unblock due to hard calcium deposits or twists in the arteries.
“Calcium is like kryptonite when it comes to performing a coronary intervention,” Finley said. “It’s literally and figuratively hard and tough, making for extremely difficult stent delivery, and then, once in position, even more difficult to properly expand the stent.”
The minimally invasive procedure received U.S. Food and Drug Administration approval in late February. Based on the same technology used to destroy kidney stones so they can more easily pass through the urinary tract, the Shockwave IVL System uses waves of sonic pressure to fracture calcium buildup within a blood vessel and allow the deployment of a stent — a mesh tube that holds the artery open.
The first patient at Virtua, a 51-year-old man on dialysis to treat his chronic kidney failure, had already undergone several cardiac procedures, including bypass surgery after suffering a series of heart attacks. He was not a candidate for additional open-heart surgery, and the condition of his arteries put him at high risk for traditional atherectomy, which uses a miniature diamond-tipped drill threaded through a catheter to break through the calcium.
Finley said he felt the best and safest option was the Shockwave. Virtua’s cardiac specialists already used a version of the Shockwave device to treat peripheral artery disease and to open the femoral/iliac arteries in preparation for transcatheter aortic valve replacement. But a catheter to use in heavily calcified coronary arteries had only just earned FDA approval.
“In a patient with tortuous arteries, meaning there are a lot of twists and turns, you run a higher risk of perforating or tearing the artery if you use traditional forms of atherectomy,” he said. “This was the ideal case for Shockwave intravascular lithotripsy.”
Shockwave works by threading a catheter through the femoral or radial artery to the location of the blockage and inflating a special balloon. An electrical discharge from emitters on the catheter vaporizes the fluid within the balloon, creating a rapidly expanding and collapsing bubble that generates sonic pressure waves.
The waves pass through soft tissue and create microfractures in the calcium inside the vessel and embedded within its walls. After the calcium is cracked, a balloon fully expands the vessel and a drug-eluting stent is safely implanted to improve blood flow.
The first procedure took about an hour. The patient stayed overnight in the Camden hospital before going home. He is home now, with marked improvement in his chest pain symptoms.
“The Shockwave complements our other approaches to treating coronary blockages,” Finley said. “It is an exciting tool to have available for our patients.”