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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Intercostal embolization of a stuck rotational atherectomy burr

02 Mar 2021

An elective right coronary artery PCI was scheduled in an 83-year-old gentleman. Due to the presence of severely diffuse and calcified disease, rotational atherectomy was decided, but the burr got entrapped in the severely calcified and tortuous proximal segment of the artery...

Embolization of a rotational atherectomy burr

How should I treat underexpanded coronary stents due to severe coronary calcification?

11 Feb 2021

An 81-year-old male underwent PCI of an extensively calcified LAD coronary artery. Lesion preparation was done using cutting and scoring balloons, followed by drug-eluting stent implantation. Despite serial dilations, including the use of a very High-Pressure NC balloon, stent expansion could not be achieved...

How should I Treat underexpanded coronary stents due to severe coronary calcification?

Rotational atherectomy and trans-apical TAVI in severe calcified CAD and PAD

14 May 2020

An 83-year-old male admitted for heart failure and chest pain, needs to undergo TA-TAVI because of severe PAD and has concomitant CAD with critical calcified lesion of the ULM-LAD...

Gabriele Pesarini

Author

Gabriele Pesarini
Simone Fezzi

Author

Simone Fezzi
Rotational atherectomy and trans-apical TAVI in severe calcified CAD and PAD

Rotational atherectomy supported-PCI of a sub-occlusive calcified ostial RCA lesion through an Evolut R aortic valve

15 Apr 2020

View this case of an 81-year-old man with severely calcified critical stenosis at ostial-prox RCA...

Gabriele Pesarini

Author

Gabriele Pesarini
Mattia Lunardi

Author

Mattia Lunardi
Rotational atherectomy supported-PCI of a sub-occlusive calcified ostial RCA lesion through an Evolut R aortic valve

How to use a Rotablator as single operator

24 Mar 2020

A single operator technique simplifies the procedure and removes the dependence on having a trained assistant. Discover the tips and solutions proposed by Joshua Loh.

Dr. Joshua Loh

Author

Joshua Loh
My toolkit: How to use a Rotablator as single operator

Management of multi-vessel calcified coronary artery disease in acute myocardial infarction complicated by cardiogenic shock

17 Mar 2020

View this case of a 79-year-old woman complaining of atypical chest pain for 3 months, with diabetes and end-stage chronic kidney disease. Coronary CT revealed diffuse calcifications BUT critical coronary artery stenosis was excluded...

Author

Flavio Luciano Ribichini
Gabriele Pesarini

Author

Gabriele Pesarini
Management of multi-vessel calcified CAD in AMI complicated by cardiogenic shock

When all roads are closed, open one…

10 Feb 2020

View this case of a 57-year-old woman, with a negative cardiovascular history, but who is a heavy smoker (40xday >20 years) and hypertensive, and who suffered typical chest pain at rest. She arrived at the Emergency Room of a peripheral hospital without a cathlab facility. Her...

Author

Flavio Luciano Ribichini
Juan Gustavo Del Angel Soto

Author

Juan Gustavo Del Angel Soto
When all roads are closed, open one…

About a complex clinical decision...

14 Nov 2019

View this case of a 79-year-old male with a diagnosis of hepatocarcinoma and severe AVS, mild mitral regurgitation and AF under oral anticoagulation who was admitted for TAVI…

Author

Flavio Luciano Ribichini
About a complex clinical decision..

Undilatable calcific lesion even after rotational atherectomy

19 Dec 2019

View this very uncommon case in which balloons do not expand even after a rather aggressive rotational atherectomy: a 43-year-old male with hypertension, smoking and dyslipidemia presents with total occlusion of proximal left anterior descending artery with fresh thrombus...

Author

Flavio Luciano Ribichini
Concetta Mammone

Author

Concetta Mammone
Undilatable calcific lesion even after rotational atherectomy

An NSTEMI case due to a severe LM calcific sub-occlusive stenosis

22 Oct 2019

View this case of an 85-year-old woman, hypertensive under medical therapy with no previous medical or surgical history, who called the emergency services about chest pain and shortness of breath...

Author

Flavio Luciano Ribichini
NSTEMI case due to a severe LM calcific sub-occlusive stenosis

How should I treat with rotational atherectomy a TAVI candidate

18 Sep 2019

This is the case of an 84-year-old woman in good general condition, with severe AVS on medical management, chronic atrial fibrillation and admitted with heart failure and chest pain...

Author

Flavio Luciano Ribichini
RA after TAVI

Rotational atherectomy in anterior STEMI

20 Aug 2019

This is the case of an 83-year-old woman with arterial hypertension, hypercolesterolemia, onset of continuous chest pain at rest with anterior STEMI on ECG and medicated with ASA and Ticagrelor and transferred to the cathlab.

Author

Flavio Luciano Ribichini
Rotational atherectomy in anterior STEMI

Calcified lesions

05 Jul 2019 – From AICT-AsiaPCR 2019

Watch this LIVE demonstration from National University Heart Centre (Singapore) to discover how they managed the case of a 69 years-old male with diabetes, hypertension and hyperlipidemia suffering from a calcified triple vessel disease.

Calcified lesions

Calcified left main lesion PCI

05 Jul 2019 – From AICT-AsiaPCR 2019

Consult this session to discover the key clinical data and angiographic reference of a patient presenting with calcified left main lesion PCI.

Calcified left main lesion PCI

Complex distal left main bifurcation lesion

04 Jul 2019 – From AICT-AsiaPCR 2019

A 75-year-old male with multiple risk factors and a history of NSTEMI is admitted for staged PCI to his left main bifurcation. His vessels are diffusely calcified…

Complex distal left main bifurcation lesion

Defining together a treatment strategy for calcified CAD in a patient with multivessel disease

20 Jun 2019

This is the case of a 68 year old female patient, autonomous and physically robust. She has been diabetic for 10 years, but without cardio-vascular antecedents. She was admitted for chest pain at rest, lasting around 70 minutes with signs of STEMI in the inferior leads...

Author

Flavio Luciano Ribichini
Strategy for calcified CAD in a patient with MVD

Step-by-step decision planning on how to deal with a «simple surgical case», but a potentially troublesome PCI lesion

25 Jul 2019

This is the case of an 84 year old man, widower, with initial cognitive decay, living with his sons and daugthers - non autonomous but physically robust. He was admitted for chest pain at rest after weeks of worsening angina, and underwent coronary angiography within 48h...

Author

Flavio Luciano Ribichini
Step-by-step decision planning on how to deal with a «simple surgical case», but a potentially troublesome PCI lesion