Calcified coronary lesions often run through various complex lesions, which increases the difficulty of coronary intervention, is one of the main challenges faced by interventional cardiovascular physicians. Severely calcified lesions, or severely calcified lesions with twisted, angulated, diffused, significantly increase rates of immediate complications and early and late major adverse cardiovascular events. Correctly identifying and evaluating calcified lesions, and selecting the most appropriate treatment strategy according to the degree of coronary artery calcification are very important for improving the success rate of intervention, reducing complications, and improving the short-term and long-term prognosis of patients.The current regular interventional treatment methods for coronary calcification lesions include plain balloons, non-compliant balloons, cutting balloons, etc., but the incidence of complications is high and the rate of long-term restenosis is high, and the effect is not satisfactory. Rotary atherectomy is currently the main pretreatment method for severe calcified lesions. Rotary atherectomy combined with drug-eluting stent implantation has become an important mean for the treatment of severe calcified lesions, even complex lesions, in the DES era, and has good safety and effectiveness. However, this technique is more complicated, and in order to ensure its advantages, it needs correct and meticulous operation by an experienced interventional team. Studies have shown that the use rate of rotational atherectomy in high-capacity centers is only 3% to 5%. The reasons may be related to the expensive equipment, difficult operation and unfamiliarity with new technologies. The intra-coronary electrohydraulic shock wave balloon catheter is a device that combines electrohydraulic shock wave lithotripsy with percutaneous transluminal angioplasty. After the catheter is connected to the device and energized, the micro-transmitter installed in the balloon can generate pulsed sound pressure waves to shatter the calcified plaque inside the target lesion, enabling subsequent expansion of the lesion at low pressure. SONICO-CX intracoronary electrohydraulic shock wave balloon catheter is a new type of plaque remodeling device, which can not only change the compliance of the artery, but also reduce the damage of the vessel wall. It provides a new option for doctors to better solve the problem of severe calcified lesions, and also brings more benefits to patients. This randomized trial was conducted to assess the efficacy/safety of intracoronary electrohydraulic shock wave lithotripsy versus rotational atherectomy based on optical coherence tomography (OCT) measurements.
Calcified coronary lesions often run through various complex lesions, which increases the difficulty of coronary intervention, is one of the main challenges faced by interventional cardiovascular physicians. Severely calcified lesions, or severely calcified lesions with twisted, angulated, diffused, significantly increase rates of immediate complications and early and late major adverse cardiovascular events. Correctly identifying and evaluating calcified lesions, and selecting the most appropriate treatment strategy according to the degree of coronary artery calcification are very important for improving the success rate of intervention, reducing complications, and improving the short-term and long-term prognosis of patients.