Successful Intravascular Lithotripsy Within a Covered Coronary Stent

Intravascular lithotripsy (IVL) has become an important method to treat calcified lesions.1 More recently, IVL has been demonstrated to allow for increased luminal gain in previously placed coronary stents.2-4 IVL has not been systematically studied within covered stents either in vitro or in vivo. In this image series, IVL was used to expand an underexpanded covered stent implanted after coronary perforation during rotational atherectomy. We hypothesized that the covered stent material did not significantly attenuate the energy impulse from IVL, allowing adequate energy to be transmitted to allow for calcium fracture.