Heart disease kills more than 600,000 people in the U.S. every year. Now, doctors at Hackensack University Medical Center and Jersey Shore University Medical Center can offer a new procedure to help prevent this disease.

Previous Options for Heart Disease

Up until now, doctors have had two ways to open up narrow, hardened arteries supplying blood to the heart:

Angioplasty, where a balloon is inflated to help open a blocked artery

Atherectomy, in which tiny rotating blades open the artery through scraping and drilling

After one or both of these procedures are done, a stent—a metal tube that helps to keep the vessel open—is usually inserted to keep the arteries open.

Unfortunately for some patients, neither of these methods are ideal. “Sometimes fatty plaque that has been there for so long goes from being soft and squishy to being hard as a rock,” says Daniel Kiss, M.D., a cardiologist at Jersey Shore. “Because the calcium is hard, plaque can’t move back against the arterial wall, the balloon can’t expand properly, and the blockage remains.”

Atherectomy comes with its own difficulties. “When you scrape the wall of the artery, the debris that falls out goes downstream into the microcirculation,” says Haroon Ahmed Faraz, M.D., interventional cardiologist at Hackensack. Doctors have to scrape enough calcium to unblock the artery—but not so much that they’ll clog the system with the debris.

A New Option Emerges

“[Until now,] there really wasn’t a great treatment to clear the way for the stent in those whose calcium had gotten hard and built-up,” Dr. Kiss says.

Doctors at Hackensack and Jersey Shore now have Intravascular Lithotripsy (IVL) as a new tool in their arsenal. IVL uses sonic pressure waves, also known as shockwaves, which creates a series of microfractures to break up the calcium without affecting the healthy vessel. “The beauty of this technology is that it attacks the calcium but leaves the healthy vessel wall alone,” Dr. Faraz says.

It’s based on the same technology that has been used for decades to safely break up kidney stones.

The minimally invasive procedure, which is done under local anesthesia, is done in conjunction with angioplasty and stenting.

First, the doctor introduces the catheter to the heart through a small incision in the patient’s arm or leg.

Then, IVL emits pressure waves to break up the calcium deposits.

“One big advantage of the shockwave is that you’re not throwing the debris anywhere,” says Dr. Faraz.

After the IVL creates fractures in the calcium, the artery can successfully be expanded at low pressure with the angioplasty balloon, then the stent can be implanted. “This procedure allows us to get the biggest stent in that we can the first time. And that should prevent patients from having to come back to the cath lab in the future. It’s really about getting the right result in the right patient the first time,” says Dr. Kiss.

Next Steps & Resources:

Meet our sources: Daniel Kiss, M.D. and Haroon Ahmed Faraz, M.D. To make an appointment with Dr. Kiss, Dr. Faraz or a doctor near you, call 800-822-8905 or visit our website.

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