Calcified lesions

Nicola Ryan and Flavio Ribichini explore the complexities of calcified left main stem disease, emphasizing the critical role of intracoronary imaging in improving patient outcomes. They discuss the practical use of mechanical circulatory support and debate stenting strategies, offering expert insights on when single or dual...

Calcified bifurcation lesions remain one of the toughest challenges in interventional cardiology, combining two high-risk features into one complex scenario.

In this discussion, Dejan Milasinovic, Miroslaw Ferenc, and Mohamed Abdel Wahab explain why this subset deserves dedicated attention. They highlight the critical role of intra-coronary imaging to...

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...

Due to a lack of randomised evidence, this randomised controlled trial (RCT) aimed to compare the safety and efficacy of IVL and ELCA with RA in treating heavily calcified coronary lesions before drug-eluting stent implantation.

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.

Aaysha Cader provides her take on the ECLIPSE trial presented by Gregg W. Stone at ACC.25 in Chicago.

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...

A 52-year-old male presenting with angina (CCS II) and normal LV function. Angiography revealed a long, severely calcified lesion in the proximal and mid-LAD, which was undilatable during a previous PCI.

The lesion was prepared using Rotablator (1.5 Burr), cutting balloon, Shockwave, and NC balloon, guided by...

An 89-year-old male presented with worsening HF symptoms and a history of permanent AF and chronic renal failure. TTE confirmed severe AS, while coronary angiography revealed single vessel disease. He was referred to a heart valve center for further evaluation, where multislice computed tomography showed a...

Nicola Ryan provides her take on the ECLIPSE trial presented by Ajay J. Kirtane at TCT 2024 in Washington.

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

Thanks to the contribution of a team of interventional cardiologists from around the globe, get the international perspective on Late-breaking Clinical Trials and Science released at TCT 2024 - check out the list below.

An 82-year-old woman with diabetes, hypertension, a history of Micra and RCA PCI 2 years later, was admitted for NSTEMI. The coronary angiography showed a very calcified distal left main stenosis, a significant and calcified ostial LAD stenosis (medina: 1 1 0), confirmed by IVUS. She...

This session explores the challenges of treating calcified lesions during percutaneous coronary intervention (PCI). Learn how calcium can impede stent deliverability and expansion, potentially leading to thrombosis and restenosis. Discover the innovative Shockwave IVL technology, which uses sonic pressure waves to fracture calcium without harming surrounding...

A 75-year-old male with hypertension, dyslipidemia and a lot of co-morbidities presented a positive echo stress test. The coronary angiography showed diffuse calcified disease on LAD, CX, OM1 and RCA. There is significant stenosis on ostial RCA, mid LAD, mid CX and OM1.
After physiology assessment...

Analyze this case to find out how to successfully manage a patient with severe aortic stenosis and severely calcified peripheral vasculature referred to transcatheter aortic valve implantation.

Managing calcified lesions is always a challenge, and while rotablation is the default technique, other methods must sometimes be considered, especially for eruptive calcified nodules, such as Shockwave, OPN balloon, or orbital atherectomy.

In challenging anatomies, the Prostyle may get stuck due to calcification, leading to urgent vascular surgery and increasing the operative risk for the patients. This tutorial shows a step-by-step bailout procedure to mitigate risks and ensure patient safety.

Additional balloon-based plaque modification after ineffective intravascular lithotripsy of a heavily calcified ostial CX