An 83-year-old patient identified only by the surname A had hypertension and diabetes, as well as heart failure and severe mitral regurgitation caused by a previous myocardial infarction. The patient was diagnosed with severe calcified coronary artery stenosis and complete arterial occlusion, but treatment was difficult due to advanced age and multiple structural heart abnormalities.
In this regard, Kyung Hee University Hospital said on Wednesday that its interventional cardiology team has adopted coronary intravascular lithotripsy (IVL), a procedure that safely fractures calcium deposits inside blood vessels, helping minimize the risk of vascular injury in elderly and high-risk patients.
Coronary artery disease occurs when blood vessels supplying blood to the heart become narrowed or blocked. Calcified lesions, in which calcium accumulates in arterial walls and hardens over time due to aging or chronic disease, are observed in about 20% to 30% of patients undergoing coronary interventions and are particularly common among older adults.
“Severe calcification can completely block coronary arteries, reducing blood flow and leading to serious myocardial infarction or heart failure,” said Dr. Lee Jin-ho, a cardiologist at Kyung Hee University Hospital. “If left untreated, patients may suffer severe chest pain and shortness of breath and can ultimately face a fatal outcome, making early diagnosis and treatment critical.”
Conventional treatment has relied on balloon angioplasty or stent implantation to widen narrowed arteries. However, severe calcification can prevent stents from expanding properly and increase the risk of tearing blood vessels during the procedure. Open-heart surgery is also often too burdensome for elderly patients.
Coronary intravascular lithotripsy (IVL) is a newer procedure that uses acoustic pressure waves generated from a specialized catheter inserted into the artery to selectively fracture hardened calcium deposits. The treatment prepares the vessel for more effective stent placement.
“Because the procedure does not damage surrounding soft vascular tissue, it can reduce the risk of complications such as vessel perforation or dissection,” Lee said. “After creating microscopic fractures in calcified plaques, stents can be implanted with better vessel wall apposition, which may reduce long-term restenosis and improve patient outcomes.”
He added, “IVL carries a lower risk of vascular injury than conventional approaches and can shorten procedure times, significantly reducing the burden on elderly and high-risk patients. It offers a safe and effective treatment option for patients who previously could not undergo stent procedures or were hesitant because of complication risks.”
Lee also said the hospital plans to establish systematic and precise patient-selection criteria for IVL procedures and continue building clinical experience based on its expertise in complex cardiovascular interventions and multidisciplinary care system.
In addition, Kyung Hee University Hospital’s interventional cardiology team actively performs advanced procedures for complex cardiovascular diseases, including angina, myocardial infarction and heart valve disorders.
The team includes Drs. Kim Won, Woo Jong-shin, Na Jong-cheon and Lee Jin-ho.