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. 2023 Feb 16;10(1):e002182. doi: 10.1136/openhrt-2022-002182

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© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Detailed depiction with optical coherence tomography (OCT) of the effects of intravascular lithotripsy throughout a heavily calcified undilatable lesion. (A) Underexpansion of a 4.0 mm high-pressure balloon in a calcified proximal left anterior descending artery. (B and C) OCT cross-sectional frames showing the presence of thick calcium sheets surrounding the vessel. (D–F) OCT three-dimensional long view reconstruction and cross-sectional frames after the use of lithotripsy showing the cracks formed in the calcium surface fracturing its body creating deep grooves.