Euro4C Cases - the management of complex patients with calcified CAD

An 83-year-old woman with multiple cardiovascular risk factors presented with non-ST-elevation myocardial infarction (NSTEMI) and severe left ventricular dysfunction with very low ejection fraction, complicated by haemodynamic instability in the setting of complex heavily calcified coronary disease.

How should such a high-risk case be managed?

Complex PCI of a calcified vessel in a 72-year-old gentleman with NSTEACS and markedly reduced LV function.

This case highlights how to tackle a challenging access and a difficult coronary lesion in a patient with scarce hemodynamic reserve.

Analyse this case to find out how to successfully manage a patient with a severely calcific left main stenosis and severely reduced ejection fraction.

A stalled rota burr is every operator’s nightmare — but being prepared can make all the difference. In this case, an 80-year-old patient with severe calcification in the proximal and mid LAD faces exactly that complication.

What’s your first step to safely retrieve the burr and complete...

This case illustrates how a fragile patient with severe three-vessel disease involving LM/LAD was treated. Watch now to find out more, and share your thoughts!

We present the case of an 83-year-old man admitted with chronic coronary syndrome.

Coronary angiography revealed critical long calcified LAD stenosis. Complex PCI with different plaque modification techniques and intravascular imaging guiding was necessary to reach the success.

A 72-year-old male patient with stable coronary artery disease was admitted for recurrence of angina (CCS II/III). Coronary angiography revealed significant stenosis in the mid-portion of RCA. Ad hoc PCI of RCA was unsuccessful due to an uncrossable lesion...

In this case, the authors offer their perspective on treating a highly calcified circumflex coronary artery while dealing with a very unfavourable angle in a patient with extensive and known coronary disease.

A 76-year-old man with multiple cardiovascular risk factors presents with unstable angina, despite optimal medical therapy. Facing a complex, tight, and calcified lesion, the decision between PCI and CABG is critical. Join us as we discuss his diagnosis, risk assessment, and approach to treatment, and see...

This case demonstrates the strategy and toolbox for treating a patient with chronic kidney disease and heavily calcified multivessel disease.