{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:25:21Z","timestamp":1792603521511,"version":"4.5.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The coral reef aorta (CRA) is a rare disease of extreme calcification in the juxtarenal aorta. These heavily calcified exophytic plaques grow into the lumen and can cause significant stenoses, leading to visceral ischaemia, renovascular hypertension, and claudication. Surgery or percutaneous intervention with stenting carries a high risk of complications and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 67-year-old female had presented with severe hypertension and exercise limiting claudication for 18\u2009months. On evaluation, she was found to have severe bilateral renal artery stenoses with juxtarenal CRA causing subtotal occlusion. Both renal arteries were stented. For CRA, we used intravascular lithotripsy (IVL) assisted plain balloon angioplasty to minimize possibilities of major dissection and perforation and avoided chimney stent-grafts required to protect visceral and renal arteries. We used a double-balloon technique using a 6 \u00d7 60 mm IVL Shockwave M5 catheter and a 9 \u00d7 30 mm simple peripheral balloon catheter, inflated simultaneously at the site of CRA as parallel, hugging balloons to have an effective delivery of IVL. Shockwaves were given in juxta\/infrarenal aorta to have satisfactory dilatation without any complication. The gradient across aortic narrowing reduced from 80 to 4\u2009mmHg. She had an uneventful recovery and has remained asymptomatic at 6-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>When CRA is juxtarenal with no safe landing zones for stent-grafts, IVL may be a safe, less complex and effective alternative to the use of juxtarenal aortic stent-graft with multiple chimney or snorkel stent-grafts. This is the first report of a novel use of IVL to treat CRA.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab102","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T18:17:07Z","timestamp":1618597027000},"source":"Crossref","is-referenced-by-count":19,"title":["Novel use of intravascular lithotripsy for coral reef aorta: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0847-8530","authenticated-orcid":false,"given":"Milan C","family":"Chag","sequence":"first","affiliation":[{"name":"Department of Cardiology, Care Institute of Medical Sciences, Sola, Off S. G. Highway, Ahmedabad 380060, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuj A","family":"Thakre","sequence":"additional","affiliation":[{"name":"Smt. NHL Municipal Medical College, Ahmedabad 380006, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"key":"2021071002572947200_ytab102-B1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1055\/s-0031-1278258","article-title":"The coral reef aorta\u2014a single centre experience in 70 patients","volume":"16","author":"Grotemeyer","year":"2007","journal-title":"Int J Angiol"},{"key":"2021071002572947200_ytab102-B2","first-page":"57","article-title":"Influence of balloon size on short-term and long-term results of balloon pulmonary valvuloplasty","volume":"14","author":"Rao","year":"1987","journal-title":"Tex Heart Inst J"},{"key":"2021071002572947200_ytab102-B3","first-page":"903","article-title":"\u201cCoral reef\u201d atherosclerosis of the suprarenal aorta: a unique clinical entity","volume":"1","author":"Qvarfordt","year":"1984","journal-title":"J Vasc Surg"},{"key":"2021071002572947200_ytab102-B4","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.avsg.2009.11.006","article-title":"Analysis of calcifications in patients with coral reef aorta","volume":"24","author":"Schlieper","year":"2010","journal-title":"Ann Vasc Surg"},{"key":"2021071002572947200_ytab102-B5","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3400\/avd.cr.16-00133","article-title":"Severe obstructive calcification of the descending aorta: a case report of \u201ccoral reef aorta\u201d","volume":"10","author":"Ishigaki","year":"2017","journal-title":"Ann Vasc Dis"},{"key":"2021071002572947200_ytab102-B6","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1055\/s-0030-1247382","article-title":"Occlusive aortic disease as coral reef aorta\u2014experience in 80 cases","volume":"135","author":"Sagban","year":"2010","journal-title":"Zentralbl Chir"},{"key":"2021071002572947200_ytab102-B7","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1016\/j.athoracsur.2007.11.053","article-title":"Treatment of symptomatic coral reef aorta by endovascular stent-graft placement","volume":"85","author":"Holfeld","year":"2008","journal-title":"Ann Thorac Surg"},{"key":"2021071002572947200_ytab102-B8","doi-asserted-by":"crossref","first-page":"e229179","DOI":"10.1136\/bcr-2019-229179","article-title":"Treatment of symptomatic coral reef aorta by a nations self-expanding stent","volume":"12","author":"Vijayvergiya","year":"2019","journal-title":"BMJ Case Rep"},{"key":"2021071002572947200_ytab102-B9","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.jvscit.2017.02.008","article-title":"Covered endovascular repair of the paravisceral aorta","volume":"3","author":"Plimon","year":"2017","journal-title":"J Vasc Surg Cases Innov Tech"},{"key":"2021071002572947200_ytab102-B10","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.jacc.2017.06.022","article-title":"Safety and performance of lithoplasty for treatment of calcified peripheral artery lesions","volume":"70","author":"Brodmann","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"2021071002572947200_ytab102-B11","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/ccd.27943","article-title":"Primary outcomes and mechanism of action of intravascular lithotripsy in calcified, femoropopliteal lesions: results of Disrupt PAD II","volume":"93","author":"Brodmann","year":"2019","journal-title":"Catheter Cardiovasc Interv"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/4\/ytab102\/37059041\/ytab102.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/4\/ytab102\/37059041\/ytab102.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T06:58:51Z","timestamp":1625900331000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab102\/6225795"}},"subtitle":[],"editor":[{"given":"Aref Bin","family":"Abdulhak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Dimitrios","family":"Terentez-Printzios","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Alessia","family":"Azzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Bretty Sydney","family":"Bernstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Fabienne","family":"Vervaat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,4,1]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4,5]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab102","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,4,1]]},"published":{"date-parts":[[2021,4,1]]},"article-number":"ytab102"}}