After Atherectomy: Shockwave Medical Preps For Success

An increasing proportion of patients are presenting to cath labs with calcified plaque, and emerging cardiovascular interventions are driving the demand for calcium debulking technologies that are more benign than conventional atherectomy or balloon angioplasty. Shockwave Medical’s novel platform for debulking calcified plaque in vessels is based on lithotripsy, the use of mechanical energy to fracture kidney stones; the start-up believes it has a technology that’s specific for calcium and benign to healthy tissue.

Even the greatest advances in medicine have their drawbacks. Take vascular disease. Interventional cardiologists today are asked to treat far more rigid, resistant plaque than they did three deades ago. Todd Brinton, MD, an interventional cardiologist at Stanford University Medical Center says, “These days we rarely see the kind of soft thrombus lesions that Andreas Gruentzig described when he developed angioplasty.” The advent of drugs (such as statins), stenting, and angioplasty are enabling people to live longer lives. But this gives calcified plaque – hard as concrete and as difficult to remove – time to form along vessel walls, making them stiff and immobile. Interventionalists must get in there with devices to drill, sand, or shave off the plaque. But, Brinton says, “Despite the development of debulking devices, interventionalists are usually using the simplicity of balloon angioplasty from the late 1970s to treat modern-day disease.”

The longer lifespans – coupled with our changing lifestyles – also give rise to metabolic syndrome, type 2 diabetes, and...

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