Intravascular coronary lithotripsy for the treatment of iatrogenic calcium embolization: The “block and crack” technique

Intracoronary calcium embolization during percutaneous procedure is a very rare and unpredictable event, that can lead to serious complications and even expert operators could face some technical issues to solve it. This case report presents a technique called “block and crack” used to manage iatrogenic intracoronary calcium embolization of left anterior descending coronary artery. The technique involves implanting a drug eluting stent (DES) to block the embolus against the vessel wall, followed by the use of lithotripsy balloon inflated inside the DES to crack the calcium and achieve a better stent expansion. This technique allowed to avoid further distal calcium embolization as well as to minimize residual stenosis degree after stent implantation.