Case submitted by Robert Riley, MD, The Christ Hospital

Summary: Baseline angiogram shows extensive iliofemoral calcification in cardiogenic shock patient. Transfemoral delivery of Impella CP attempted, but device won’t advance. Shockwave IVL delivered to iliac artery to fracture calcium. Post-IVL, Impella device advances smoothly through iliac artery.

Case submitted by Thierry Lefevre, Institut Cardiovasculaire Paris Sud

Summary: Nearly occluded right coronary artery (RCA) that was a planned rotablation case; however guidewire went through and 3.0 Shockwave IVL catheter followed and opened up nicely after 40 pulses; once the RCA was open, we realized we undersized and used a 3.5 IVL – all 80 pulses in the two ostial segments; implanted a 3.5 x 18 drug-eluting stent (DES).