Advanced age, diabetes mellitus, hypertension, and renal insufficiency contribute to high incidence of calcium deposition in blood vessels. Coronary calcification may impede stent delivery and deployment, leading to suboptimal stent expansion and stent failure. Atheroablative technologies act only on the superficial calcium. Intravascular lithotripsy (IVL) is a novel technique based on an established treatment strategy for renal calculi, in which multiple lithotripsy emitters deliver localized pulsatile sonic pressure waves to circumferentially fracture superficial and deep vascular calcium.