UI Heart and Vascular team performs first coronary lithotripsy procedure in Iowa

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Newly FDA-approved procedure uses sonic pressure waves to break up calcium build-up in heart arteries.

The University of Iowa's Heart and Vascular team is the first in the state of Iowa to perform a procedure that uses sonic pressure waves to break up calcium build-up in heart arteries. The procedure, called intravascular lithotripsy, was approved by the FDA in February 2021 to treat severely calcified coronary artery disease.

Coronary stent procedures are commonly used to treat coronary artery disease, the leading cause of death in Americans. However, about 10% of coronary artery disease patients seen at UI Hospitals & Clinics have severe calcium build-up in their artery walls, which can reduce the effectiveness of stents and may limit treatment alternatives. Intravascular lithotripsy provides an additional treatment option for more complex coronary artery disease cases with severe calcium build-up.

James Rossen, MD, the lead cardiologist on the care team that completed the first lithotripsy procedure in March, says that candidates for the procedure may have challenging heart narrowings or severe heart muscle weakness. 

“When severe calcification is present in the main artery, bypass surgery, an alternative to stents, is not always feasible,” says Rossen. “Other treatments to remove calcium have a higher risk for complications, potentially leading to blockage of one of the major branch arteries. The lithotripsy procedure allows us to treat the severe calcium prior to insertion of stents in the main artery and both branches, reducing the risk of a complex surgery.”

The lithotripsy procedure is performed using a catheter that is threaded into the narrowing from the wrist or leg artery and delivers sonic pressure waves to create a series of microfractures to breakup problematic calcium. The patient feels no discomfort from the energy treatment.

“UI Heart and Vascular Center is dedicated to providing Iowans with the newest and most effective treatments for severe and complex heart conditions,” says Phillip Horwitz, MD, executive director of the UI Heart and Vascular Center. “Intravascular lithotripsy is a valuable additional alternative to achieve optimal results for select patients with severely calcified heart artery disease.”