Shockwave vs. drill: which method best prepares calcified heart arteries for stents?

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

Inclusion Criteria: 1. Age ≥ 18 years; 2. Target lesion with diameter stenosis ≥ 50% (visual estimation) associated with evidence of myocardial ischemia; 3. Target lesion must be a de novo, in-situ severely calcified coronary lesion, where severe calcification is defined as: radiopacity visible prior to contrast injection and in the absence of cardiac pulsation, typically involving both sides of the vessel wall; and ≥270° circumferential calcification as evidenced by intravascular ultrasound (IVUS); 4. Target vessel reference diameter between 2.5 and 4.0 mm, with successful guidewire traversal; 5. A maximum of two non-target lesions requiring interventional treatment, which must be successfully treated prior to the target lesion; 6. Patients presenting with evidence of symptomatic or asymptomatic myocardial ischemia, stable or unstable angina pectoris, or prior myocardial infarction; 7. Signed written informed consent obtained. Exclusion Criteria: 1. Cardiogenic shock or hemodynamic instability; 2. Chronic total occlusion (CTO); 3. Requirement for intraprocedural mechanical circulatory support, such as intra-aortic balloon pump (IABP) or Impella device; 4. Acute ST-segment elevation myocardial infarction (STEMI) occurring within 1 month prior to enrollment; 5. Angiographically visible thrombus at the target lesion site; 6. Left main ostial lesion with stenosis ≥ 50%; 7. Left ventricular ejection fraction (LVEF) \< 40%; 8. New-onset stroke or transient ischemic attack (TIA) within 90 days; 9. Bypass graft lesion; 10. Coronary artery dissection of type B or greater (NHLBI classification); 11. Pregnant or lactating patients; 12. Life expectancy \< 1 year; 13. Active bleeding; 14. Renal insufficiency, defined as estimated glomerular filtration rate (eGFR) \< 60 mL/min/1.73 m²; 15. Presence of cognitive or psychiatric disorders, as confirmed by clinical diagnosis or investigator assessment; 16. Illiteracy, semi-literacy, or any visual impairment, reading/writing disability that prevents the patient from independently reading the patient information sheet and personally providing written informed consent without assistance.