# Balloon-Assisted Coronary Intravascular Lithotripsy for Large Severely Calcified Coronary Artery Stenosis

## TL;DR

This paper presents a novel technique using a lithotripsy balloon and a buddy balloon to treat severe coronary calcification in a large artery.

## Contribution

The paper introduces a new interventional technique for treating large calcified coronary arteries using available tools in a novel way.

## Key findings

- The technique successfully treated a very large coronary artery with severe calcification.
- The use of a 'buddy' balloon allowed treatment in a vessel larger than the lithotripsy balloon's maximum size.
- This is the first reported use of this approach in coronary interventions.

## Abstract

We present a patient with in-stent restenosis due to severe coronary calcification with asymmetric stent expansion and resulting stent eccentricity in a very large (6.0 mm) caliber coronary artery. We demonstrate the feasibility of using the largest commercially available coronary intravascular lithotripsy balloon (4.0 mm) along with a “buddy” balloon inflated simultaneously to treat focal coronary artery calcification in a vessel with a diameter significantly larger than the largest commercially available coronary intravascular lithotripsy balloon. To our knowledge, this is the first demonstration of this technique in coronary artery intervention.