Shockwave therapy may crack tough heart artery plaque

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Patients ≥ 18 years old * Acute or chronic coronary syndrome requiring PCI * De novo coronary lesions (excluding bypass grafts and prior stented lesions) with a target vessel reference diameter of ≥ 2.5 mm and ≤ 4.0 mm * Moderate to severe calcification, meeting one of the following criteria: • Intravascular imaging criteria: IVUS calcium score ≥ 2 points (IVUS scoring standards: a. Calcification \> 270 degrees and length \> 5 mm; b. Circumferential calcification (360 degrees); c. Calcific nodules; d. Vessel diameter \< 3.5 mm) OCT calcium score ≥ 3 points (OCT scoring standards: a. Calcification ≤ 180 degrees: 0 points; \> 180 degrees: 2 points; b. Thickness ≤ 0.5 mm: 0 points; \> 0.5 mm: 1 point; c. Length ≤ 5 mm: 0 points; \> 5 mm: 1 point) • Contrast-based classification criteria apply when intravascular imaging devices cannot pass: Coronary angiography shows clear high-density calcific shadows visible during cardiac pulsation, or clear high-density calcific shadows visible both during and without cardiac pulsation, with the length of calcific shadows on both sides of the target lesion \> 5 mm. * Willing and able to provide written informed consent Exclusion Criteria: * Patients under 18 years of age * Patients unable to provide informed consent * Pregnant or lactating female patients (pregnancy test must be performed within 7 days before surgery for women of childbearing age) * Thrombus detected by angiography or intravascular imaging * Patients with an expected life expectancy of less than 1 year * Hemodynamically unstable patients * Patients with known contraindications to heparin, anticoagulants, antiplatelet drugs, contrast agents, or other related medications * Patients with active bleeding * Patients with a new-onset stroke or transient ischemic attack (TIA) within 90 days before enrollment * Patients scheduled to undergo other cardiac interventional procedures or cardiac surgery within 30 days after PCI * Patients with ST-segment elevation myocardial infarction (STEMI) or cardiogenic shock occurring within 7 days * Severe renal insufficiency (eGFR ≤ 30 ml/min) * Left main coronary artery disease * Presence of type C-F dissection in the target vessel * Aneurysm within 10 mm of the target lesion