ShockFast Intravascular Lithotripsy Device for Treatment of Calcified Coronary Lesions

Inclusion Criteria:

1. Patients aged ≥18 years undergoing PCI for stable or unstable angina or staged procedure after successful treatment of a myocardial infarction where heart enzymes are decreasing

   Angiographic criteria:
2. Native de novo coronary lesions
3. Vessel diameter between 2.5mm - 4.0mm
4. Lesion Length: ≤40mm
5. Severe Calcification:

   1. Calcification visible on the upper and the lower sides of the vessel wall in at least two angiographic projections that differ ≥ 60° from each other
   2. Presence of severe calcified protruding noduli
6. No flow disturbances at baseline (Thrombolysis in Myocardial Infarction \[TIMI\] 3 flow at baseline)
7. Target lesion with diameter stenosis ≥70% by visual, or ≥50% with evidence of clinical ischemia

   OCT Criteria:
8. Total calcium arc \> 180° or
9. Presence of a protruding calcified noduli

Exclusion Criteria:

1. Ejection fraction less than 25%
2. Lesion located in Left Main (LM) coronary artery
3. Calcifications located mostly \> 0.5 mm from the vessel lumen.
4. Severe renal Impairment; Serum Creatinine \> 220 μmol or currently undergoing hemodialysis
5. Severe lesion tortuosity where OCT is judged impossible to cross.
6. Inability to tolerate dual antiplatelet therapy for 6 months or longer
7. Inability to obtain inform consent or deemed poorly compliant by the investigator
8. Presence of permanent pacemaker
9. Angiographic evidence of thrombus in the target vessel
10. Target lesion located at or involving within 5mm of the coronary ostium of the Left Anterior Descending artery (LAD), Left Circumflex artery (LCX)
11. Target lesion is a chronic total occlusion (CTO)
12. Presence of aneurysm within 10mm proximal or distal to the target lesion