From an interview with
Dr. Ravi Parikh, McLeod Cardiology Associates and
Dr. Carmen Piccolo, McLeod Vascular Associates

Plaque, which is a collection of calcium, cholesterol, and fat, can build up in the body’s blood vessels, restricting blood flow. This blood flow restriction can lead to multiple health issues including heart attack, stroke, and peripheral vascular disease.

As people grow older, the soft plaque in the arteries undergo changes, calcifying and becoming a hard plaque. The amount of calcification in the coronary arteries is correlated to the risk of coronary disease, vascular disease, and heart attacks.

With blocked arteries, the standard method of treatment is to open the artery with a small balloon over a catheter wire. A stent, which is a small metal mesh tube that helps keep the artery open, is then placed into the artery.

For patients with severely calcified arteries, this calcium can cause complications. The severity of the calcium build-up can limit the physician’s access to the artery with the balloon, as well as prevent placement of the stent.

At McLeod, we have multiple technologies available that allow Interventional Cardiologists to restore blood flow to the heart by safely penetrating the problematic calcium. Intravascular Lithotripsy uses sonic pressure waves, also known as Shockwaves, to fracture the calcium with minimal damage to normal tissue. It is performed through a catheter inserted into the narrowed vessel. Once the artery is opened, the blood flow is restored with the placement of a stent.

While Intravascular Lithotripsy is a useful tool in cardiac procedures, it has also become a valuable addition for more complex procedures at McLeod with Cardiac and Vascular Surgeries such as Endovascular Aortic Aneurysm Repair, minimally-invasive revascularizations and Transcatheter Aortic Valve Replacement (TAVR).

TAVR is a minimally-invasive procedure to replace a diseased heart valve. It is performed similar to a heart catheterization. The physician inserts a catheter, a long flexible thin tube with the artificial valve, through a small incision in the groin to the heart. The Shockwaves technology ensures safer access of severely calcified vessels for the precise positioning of the new valve and opens the eligibility to more patients.

In the vascular specialty, patients requiring an endovascular aneurysm repair who have severely calcified target lesions, also benefit from Intravascular Lithotripsy. An aneurysm is an enlarged, balloon-like bulge, and weakened section of a blood vessel.

The traditional surgical treatment method involves sealing off the aneurysm with the placement of an endovascular graft stent to protect it from bursting or continuing to grow. The procedure is performed using a catheter through two small injections in the groin area, so again, clear access of the artery is imperative.

Intravascular Lithotripsy can also be used to support the treatment of peripheral arterial disease, which would involve restoring blood flow by clearing blockages in the patient’s leg.

Calcium deposits in the arteries are not related to diet or any supplements taken. They occur because the cells in the blood vessels are not working as they should. This can be a sign of heart or vascular disease or simply getting older. Those with high body mass index, high blood pressure, diabetes, chronic kidney disease or a family history of calcification are more susceptible.

Calcium build-up in the arteries is not reversible, but with the new innovative therapy for the treatment of advanced heart and vascular disease, McLeod Interventional Cardiologists and McLeod Vascular Surgeons are able to safely modify the calcified plaque, returning more patients back to a quality of life they once knew.

To learn more, contact McLeod Heart and Vascular Institute.