Calcified lesions

Find all the latest content on calcified lesions published on this website.

This section revolves around the complexity of calcified coronary lesions and their treatment, from specialised balloon technology to atherectomy devices and lithotripsy. Learn all about the value of invasive imaging and coronary physiology, with many clinical cases showing various treatment modalities and strategies.

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Advanced techniques in specific clinical and anatomical settings

27 Feb 2026 – From Euro4C Annual Meeting 2026

This session addresses advanced interventional techniques tailored to complex clinical and anatomical scenarios. It emphasizes risk assessment in complex patients, strategic procedural planning for high-risk and calcified lesions, and indications for mechanical support use to improve outcomes in challenging PCI cases.

Advanced techniques in specific clinical and anatomical settings

Introducing the next era of coronary intravascular lithotripsy: an aero-volution in calcium modification

27 Feb 2026 – From Euro4C Annual Meeting

Explore the next era of coronary intravascular lithotripsy featuring innovative technology for calcium modification. This session covers the unique mechanism of action, practical application in complex cases, and recent clinical evidence supporting its safety and efficacy.

Introducing next era of coronary intravascular lithotripsy: aero-volution in calcium modification

Novel Hertz Contact intravascular lithotripsy: calcium fragmentation with zero trade-offs

27 Feb 2026 – From Euro4C Annual Meeting

This session introduces the novel Hertz Contact intravascular lithotripsy system, designed for effective calcium fragmentation without trade-offs. It covers lesion types amenable to treatment, system mechanism, optimization tips, and discusses real-world cases along with supporting clinical trial evidence.

Novel Hertz Contact intravascular lithotripsy: calcium fragmentation with zero trade-offs

Calcified left main distal trifurcation PCI - LIVE Case

A 48‑year‑old man with hypertension and diabetes mellitus presented with a recent history of thrombolysed anterior acute MI and preserved left ventricular function. Coronary angiography revealed a severely calcified ostial LAD and ostial ramus lesion, along with diffuse disease of the RCA.

The ramus was treated with...

Calcified left main distal trifurcation PCI - LIVE Case

Balloon lithotripsy added to conventional preparation before stent implantation in severely calcified coronary lesions

06 Jan 2026

In patients with severely calcified coronary lesions undergoing PCI, the BALI trial evaluated the benefit of the addition of intravascular lithotripsy to conventional lesion preparation on the composite endpoint of procedural failure and target vessel failure.

Nicola Ryan

Reviewer

Nicola Ryan
Balloon lithotripsy added to conventional preparation before stent implantation in severely calcified coronary lesions

Abstracts - Part 2

11 Dec 2025 – From GulfPCR-GIM 2025

This session compiles recent clinical abstracts addressing diverse topics in interventional cardiology. Highlights include the HYBRID-CTO approach from a prospective case series, the cardiovascular impact of empagliflozin in type 2 diabetes, off-label use of intravascular lithotripsy for resistant in-stent lesions, and experiences with non-hyperaemic pressure ratios...

Abstracts - Part 2

Calcified lesions: LIVE Educational Case from King Faisal Cardiac Center, National Guard Health Affairs- Western region - Jeddah, Saudi Arabia

11 Dec 2025 – From GulfPCR-GIM 2025

This educational session from King Faisal Cardiac Center provides a detailed examination of optimal device use in calcified coronary lesions, emphasizing the role of intracoronary imaging to improve PCI results and patient outcomes. It also offers guidance on selecting appropriate strategies for coronary bifurcation lesions through...

Calcified lesions: LIVE Educational Case from King Faisal Cardiac Center, National Guard Health Affairs- Western region - Jeddah, Saudi Arabia

Complex coronary complications

11 Dec 2025 – From GulfPCR-GIM 2025

This session addresses complex coronary complications through a series of challenging cases including dextrocardia with acute STEMI, fragile coronary anatomy risks, left main complications, and stent-related issues. It provides critical insights into recognizing and managing unexpected procedural challenges to improve patient safety.

Complication session

Coronary Pot Pourri - 2

11 Dec 2025 – From GulfPCR-GIM 2025

This session presents a diverse range of complex coronary interventions, highlighting advanced techniques and strategies. Topics include the use of ECMO support for high-risk PCI and TAVI in cardiogenic shock, innovative approaches in left main interventions, challenging stent optimisation, and management of patients with combined severe...

Coronary Pot Pourri - 2

NIRS-guided PCI: beyond calcium to precision PCI

11 Dec 2025 – From GulfPCR-GIM 2025

This session explores how near-infrared spectroscopy (NIRS) is redefining PCI by revealing what angiography cannot see. By identifying lipid-rich and vulnerable plaques, NIRS helps anticipate procedural risk and refine decision-making before stent implantation. The session shows how plaque composition, rather than calcium alone, can guide lesion...

NIRS-guided PCI: beyond calcium to precision PCI

Cracking calcium in modern PCI

10 Dec 2025 – From GulfPCR-GIM 2025

Calcified coronary lesions are a major challenge in PCI. This PCRGulf-GIM 2025 session showcases a complex case with intravascular imaging, highlighting how IVUS 123 guides each step.

From planning the procedure and understanding calcium distribution, to lesion preparation with modern modification tools, and post-PCI assessment to confirm...

Cracking calcium in modern PCI

Seeing is believing: OCT-guided calcium modification in complex PCI

10 Dec 2025 – From GulfPCR-GIM 2025

Explore the management of heavily calcified LAD lesions in this PCRGulf-GIM 2025 session. Discover how OCT imaging guides lesion assessment, differentiates superficial from deep calcium, and informs the need for plaque modification. Learn when and how to use orbital atherectomy or intravascular lithotripsy, and follow the...

Seeing is believing: OCT-guided calcium modification in complex PCI

Complex bifurcation interventions

10 Dec 2025 – From GulfPCR-GIM 2025

This session examines complex bifurcation interventions, addressing challenging cases such as isolated Medina 0,0,1 left main bifurcation and imaging-guided trifurcation angioplasty in acute coronary syndromes. It emphasizes strategic approaches and device selection to overcome anatomical complexities, manage complications, and achieve successful outcomes in bifurcation PCI.

Complex bifurcation interventions

Abstracts session 1

10 Dec 2025 – From GulfPCR-GIM 2025

This abstracts session presents contemporary research and clinical insights in interventional cardiology, covering topics such as colchicine therapy post-stenting, ranolazine use in chronic coronary syndrome, artificial intelligence applications in quantitative coronary analysis, and optimization techniques in transcatheter aortic valve implantation. It also explores novel predictors of...

Abstracts session 1

Calcified lesions: caught between a rock and a hard place

10 Dec 2025 – From GulfPCR-GIM 2025

This session focuses on the challenges of treating calcified coronary lesions, emphasizing the use of intravascular ultrasound (IVUS)-guided rotablation and the limitations of rotatripsy in complex bifurcation angioplasty. It covers innovative strategies including off-label Shockwave lithotripsy in stented lesions, management of calcified nodules, and approaches to...

Calcified lesions: caught between a rock and a hard place

Challenging cases from the East

10 Dec 2025 – From GulfPCR-GIM 2025

This session from Eastern cardiology centers addresses complex interventional challenges including recurrent left internal mammary artery (LIMA) failure, management of transcatheter aortic valve implantation (TAVI) complications, and treatment of heavily calcified coronary lesions. Through detailed case presentations and key learnings, it offers valuable insights into successful...

Challenging cases from the East

A randomised, multicenter, non-inferiority comparison of intravascular lithotripsy and super-high-pressure non-compliant balloons for treatment of calcified and refractory coronary lesions - The VICTORY trial

27 Oct 2025

Mirvat Alasnag provides her take on the VICTORY trial presented by Matthias Bossard at TCT 2025 in San Francisco.

Dr. Mirvat Alasnag

Author

Mirvat Alasnag
VICTORY: Intravascular lithotripsy vs. super-high-pressure PTCA in calcified and refractory coronary lesions

Calcified coronary lesions

21 Oct 2025

This freshly updated chapter extensively describes percutaneous tools and techniques to assess and treat challenging calcified lesions.

Authors :

Farrel Hellig, Pieter Van Wyk, Emanuele Barbato, Shaheen Pandie
Calcified coronary lesions

Retrievals, foreign bodies and entrapments

11 Oct 2025 – From AICT-AsiaPCR 2025

This session addresses the complexities of retrievals, foreign bodies, and entrapments in interventional cardiology. It presents clinical cases illustrating percutaneous retrieval techniques, management of catheter fractures, iatrogenic dissections, and innovative solutions for challenging scenarios. Emphasis is placed on precision, prevention strategies, and effective problem-solving to mitigate...

Coronary complications and rescue cases

11 Oct 2025 – From AICT-AsiaPCR 2025

This compelling session addresses complex coronary complications and rescue cases encountered in the cath lab. Through a series of challenging case studies, it highlights critical scenarios such as silent coronary artery threats, procedural nightmares, coronary perforations, and innovative rescue strategies that transform high-risk situations into successful...

Coronary complications and rescue cases