Intravascular lithotripsy (IVL) has emerged as a novel therapy for the treatment of coronary calcification. Numerous studies have reported the safety and efficacy of IVL in calcified coronary lesions, while IVL balloon-uncrossable calcified coronary lesions are sometimes encountered in clinical practice. This case report represents a novel technique called "modified leopard-crawl" to advance the IVL balloon antegradely by creating significant calcium cracking forward when the enhanced stent visualization system reveals that the distal emitter seems adjacent to calcification. This technique might be a valuable alternative when conventional procedures fail and has the potential to enhance the clinical applicability of IVL in daily practice.
Keywords: IVUS; OCT; PCI; coronary calcification; intravascular lithotripsy.
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