Euro4C Cases - the management of complex patients with calcified CAD

Euro4C stands for the Cardiac Care of Calcified and Complex patients in response to a growing problem within the aging population. Its mission is to work on improving the clinical outcomes of complex patients with advanced, diffuse and calcified atherosclerotic CAD, often presenting in critical conditions and left ventricular dysfunction.

In this section you will find a selection of cases on the subject of the management of complex patients with calcified CAD, submitted by members of the Euro4C Group. Find out more about the members of the Euro4C Editorial Team.

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37 results

Expect trouble when calcium meets tortuous anatomy

01 Aug 2024

This case illustrates the challenges of managing a previously bypassed patient in an acute setting with LM disease and high calcium burden involving LAD and Cx ostias, and occlusion of the venous graft towards the Cx. The tortuous anatomy is a further hurdle to management and choice...

Anass Maaroufi

Author

Anass Maaroufi

Author

Sascha Paetzold
Dr. Gabor G. Toth

Author

Gabor G. Toth
Expect trouble when calcium meets tortuous anatomy

Double trouble: uncrossable calcified lesion complicated with iatrogenic ostial dissection

11 Apr 2024

How should this 74-year-old woman with HTN, DM, LVEF 45 %, inferior hypokinesia, and no valvular disorders be managed after presenting with a subacute inferior STEMI of less than 24 hours? Before uncovering the authors' approach, provide your analysis!

Judit Andréka

Author

Judit Andréka
Günther Prenner

Author

Günther Prenner

Author

Sascha Paetzold
Dr. Gabor G. Toth

Author

Gabor G. Toth
Double trouble: uncrossable calcified lesion complicated with iatrogenic ostial dissection

Navigating complexity: surgical valve degeneration and complex coronary artery disease in a multimorbid patient

14 Dec 2023

How would you treat this 83-year-old male patient with LM, MVD, RCA CTO, severely reduced EF, and constrictive surgical valve?

Sadeek Sidney Kanoun Schnur

Author

Sadeek Sidney Kanoun Schnur

Author

Albrecht Schmidt
Dr. Gabor G. Toth

Author

Gabor G. Toth
Navigating complexity: surgical valve degeneration and complex CAD in a multimorbid patient

Shock the rock with more IVL impulses, and get more gain!

20 Sep 2023

How would you treat this 81-year-old male patient with HTN, diabetes, dyslipidemia, peripheral vasculopathy, previous coronary angioplasty and prostatic adenocarcinoma, who was admitted for effort angina and positive stress test?

Author

Flavio Luciano Ribichini
Concetta Mammone

Author

Concetta Mammone
Mattia Lunardi

Author

Mattia Lunardi
Shock the rock with more IVL impulses, and get more gain!

Die Hard: high-risk PCI in calcified LM and severe LV dysfunction

14 Jun 2023

How would you treat an extremely calcified sub-occluded LM in a 72-year-old man presenting on "dependent stability and sliding on inotropes"(*), refused by surgery?

(*) INTERMACS III to II

Author

Flavio Luciano Ribichini
Gabriele Pesarini

Author

Gabriele Pesarini
Mattia Lunardi

Author

Mattia Lunardi
Die Hard: high-risk PCI in calcified LM and severe LV dysfunction

IVUS post-rotablator: the older the calcium, the newer the treatment

31 Jan 2023

How would you treat a 90-year-old female patient with HTN, dyslipidaemia, paroxysmal AF, CCS and CKD, whose stable angina CCS II has been worsening for a few months and whose angio reveals severe calcified stenosis of the proximal and middle LAD? 

Dario Tino Bertolone

Author

Dario Tino Bertolone
Marta Belmonte

Author

Marta Belmonte

Author

Jeroen Sonck
IVUS post-rotablator: the older the calcium, the newer the treatment

Porcelain aorta, calcified aortic valve, and calcified left main: what comes first, the valve or the artery?

08 Nov 2022

How would you treat this 76-year-old male patient with severe AS symptomatic for angina, sinus rhythm with RBBB, previous bilateral CEA, and total occlusion of both the left CCA and the subclavian?

Author

Flavio Luciano Ribichini
Petros Dardas

Author

Petros Dardas
Beatriz Vaquerizo

Author

Beatriz Vaquerizo
Porcelain aorta, calcified aortic valve, and calcified left main: what comes first, the valve or the artery?

A case of severe ischemic cardiomyopathy

01 Aug 2022

Find out more about how the authors managed a 53-year old male with ischemic cardiomyopathy, EF 25 %, and calcified 3-vessel disease ! 

Wijnand Den Dekker

Author

Wijnand Den Dekker
Mahmoud-Karim

Author

Karim Mahmoud
A case of severe ischemic cardiomyopathy

A case of severe aortic stenosis and severe calcified ostial RCA disease

01 Jun 2022

Techniques to manage simultaneously severe calcified aortic stenosis and severe heavily calcified ostial RCA disease combining TAVI and ROTABLATION.

Petros Dardas

Author

Petros Dardas
Nikolaos Mezilis

Author

Nikolaos Mezilis
A case of severe aortic stenosis and severe calcified ostial RCA disease

How to manage a calcified LM bifurcation?

05 Apr 2022

Find out more about an 87-year-old male patient with PCI mid-LAD with BMS 9/1998, several risk factors, preserved LVEF and eGFR, symptomatic with unstable angina, and on medical therapy...

Konstantinos Bermpeis

Author

Konstantinos Bermpeis
Marta Belmonte

Author

Marta Belmonte
Prof. Emanuele BARBATO

Author

Emanuele Barbato
How to manage a calcified LM bifurcation?