Agents which dissolve hydroxyapatite may synergize with intravascular lithotripsy (IVL) to treat calcium plates more extensively, facilitating greater penetration of drug-coated balloons delivered agents and maintain gain in lumen area without stenting.

Dissolving hydroxyapatite could potentially allow more frequent use of high-pressure balloons without IVL or atherectomy to fracture calcium plates, offering a lower cost approach.

Other mechanisms such as debonding between calcium plate and fibrous tissue junctions may also be enhanced with IVL and calcium-modifying agents to improve calcified vessel compliance.