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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A large-scale, randomized trial of orbital atherectomy vs. conventional balloon angioplasty in severely calcified coronary arteries prior to DES implantation (ECLIPSE)

30 Oct 2024

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

Nicola Ryan

Author

Nicola Ryan
A large-scale, randomized trial of orbital atherectomy vs. conventional balloon angioplasty in severely calcified coronary arteries prior to DES implantation (ECLIPSE)

Less is sometimes more

09 Jan 2025

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

Judit Andréka

Author

Judit Andréka

Author

Sascha Paetzold
Dr. Gabor G. Toth

Author

Gabor G. Toth
Less is sometimes more

PCR @ TCT 2024 - Get the international perspective!

27 Oct 2024

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.

PCRonline @ TCT 2024 - get the international perspective!

Complex calcified left main bifurcation - LIVE case

05 Oct 2024 – From AICT-AsiaPCR 2024

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...

Complex calcified left main bifurcation  - LIVE case

Cracking new horizons across all calcium morphologies

04 Oct 2024 – From AICT-AsiaPCR 2024

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...

Cracking new horizons across all calcium morphologies

Optimising outcomes in treating multivessel disease - LIVE case

04 Oct 2024 – From AICT-AsiaPCR 2024

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...

Optimising outcomes in treating multivessel disease - LIVE case

Hostile iliac access managed with IVL - How far can we go?

10 Oct 2024

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.

Simone Fezzi

Author

Simone Fezzi

Author

Flavio Luciano Ribichini
Hostile iliac access managed with IVL - How far can we go?

Fighting with calcium is always a struggle

12 Sep 2024

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.

Petros Dardas

Author

Petros Dardas
Nikolaos Mezilis

Author

Nikolaos Mezilis
Fight with calcium is always a struggle

How to retrieve your Prostyle when it gets stuck

01 Jul 2024

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.

Omar A. Oliva

Author

Omar Oliva
Dr. Antoine Sauguet

Author

Antoine Sauguet
How to retrieve your Prostyle when it gets stuck

Supplementary super-high pressure balloon-based plaque modification after intravascular lithotripsy

02 Jul 2024

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

Kambis Mashayekhi

Author

Kambis Mashayekhi
Fabiola Costa

Author

Fabiola Costa
Supplementary super-high pressure balloon-based plaque modification after intravascular lithotripsy

Calcified lesions: one big challenge; several good options

17 May 2024 – From EuroPCR 2024

This session delves into the management of calcified coronary lesions, presenting various techniques and tools to address this common challenge. It covers topics such as the use of drug-coated balloons, rotational atherectomy, intravascular lithotripsy, and high-pressure non-compliant balloons. The session also includes a meta-analysis on the...

Calcified lesions: one big challenge; several good options

Complication occurring during PCI of calcified coronary lesions

17 May 2024 – From EuroPCR 2024

Join this in-depth session on the complications encountered during PCI of calcified coronary lesions, featuring real-world challenges like no flow with coronary dissection, stuck wires, and non-dilatable lesions. From the "Kokeshi phenomenon" to IVL-induced RCA dissection, this session highlights key lessons and red flags, emphasizing the...

Navigating Complications in Calcified Coronary PCI

Advancements in intracoronary imaging and intervention: unmasking vulnerable plaques and optimising durable PCI outcomes

16 May 2024 – From EuroPCR 2024

Delve into this EuroPCR 2024 session to gain insights into NIRS IVUS, exploring its applications, supported by current data, and understanding its clinical significance. Learn how to utilize NIRS IVUS in PCI planning through case examples, addressing lesion characteristics such as length and calcific nodules. Explore local...

Advancements in intracoronary imaging and intervention: unmasking vulnerable plaques and optimising durable PCI outcomes

Cracking open the discussion on the clinical experience with intravascular lithotripsy in acute coronary syndromes

16 May 2024 – From EuroPCR 2024

Explore this session to uncover the common association between calcium and acute coronary syndrome, and how intravascular lithotripsy (IVL) offers a safe solution for calcified lesions, with comparable procedural success rates. However, note that ACS cases involving calcium may lead to higher major adverse cardiac events...

Cracking open the discussion on the clinical experience with intravascular lithotripsy in acute coronary syndromes

Optimising treatment for patients with severe calcified lesions: the role of orbital atherectomy

In this session featuring a LIVE case demonstration from Madrid, Spain, gain insights into identifying calcified lesions requiring plaque modification, effectively guiding lesion treatment with OCT support, and correctly applying orbital atherectomy, while sharing experiential knowledge step by step.

Optimising treatment for patients with severe calcified lesions: the role of orbital atherectomy

Mastering the future of PCI with drug-coated balloons

16 May 2024 – From EuroPCR 2024

Join this session dedicated to drug-coated balloons (DCB) to delve into the evolution of angioplasty with DCBs in the U.S. Learn about the established standard of care, balancing efficacy and safety in treating in-stent restenosis (ISR). Gain insights into the fundamental principles of angioplasty with DCB...

Mastering the future of PCI with drug-coated balloons

Identification and treatment of (sub)clinical transcatheter valve thrombosis

16 May 2024 – From EuroPCR 2024

This session offers a practical guide to CT diagnosis of HALT/RLM, highlighting the importance of taking HALT/RLM seriously and providing insights into approaching HALT/HAM and the potential impact of pharmacotherapy. Gain knowledge on determining leaflet thickening and mobility through MSCT, receive updates on antithrombotic treatment strategies...

Identification and treatment of (sub)clinical transcatheter valve thrombosis

Essentials in the management of calcified coronary stenosis

16 May 2024 – From EuroPCR 2024

This session focuses on the essentials of managing calcified coronary stenosis, including diagnostic pitfalls, selection strategies for appropriate plaque modification devices, and the safe and effective adoption of specific tools and techniques. Through interactive case discussions, attendees will learn how to effectively evaluate and treat calcified...

Essentials in the management of calcified coronary stenosis

First results of randomised trials on advanced plaque modification techniques and intracoronary imaging

16 May 2024 – From EuroPCR 2024

This session presents the first results of randomized trials investigating the use of advanced plaque modification techniques, such as rotational atherectomy, lithotripsy, and laser atherectomy, as well as the role of intracoronary imaging (OCT and IVUS) in guiding percutaneous coronary intervention (PCI). The session aims to...

First results of randomised trials on advanced plaque modification techniques and intracoronary imaging

How to obtain the best PCI results in calcified lesions

16 May 2024 – From EuroPCR 2024

This session features selected clinical case submissions that explore various strategies and techniques for achieving optimal PCI outcomes in patients with calcified coronary lesions. Participants will learn about plaque modification approaches, the use of IVUS guidance, and innovative ways to overcome the challenges posed by heavily...

How to obtain the best PCI results in calcified lesions