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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PCR's Got Talent Round 1 - Session 2

20 May 2025 – From EuroPCR 2025

Join the dynamic PCR's Got Talent Round 1 - Session 2 featuring cutting-edge research and innovations in interventional cardiology. Highlights include complex CTO PCI strategies, valve comparisons in TAVI for small annuli, PFO closure outcomes, long-term PCI durability, CT-guided robotic PCI, pacemaker prediction post-TAVI, and much...

PCR's Got Talent Round 1 - Session 2

Nurses and allied professionals clinical cases session

20 May 2025 – From EuroPCR 2025

Highlighting the critical role of nurses and allied professionals, this session presents clinical case discussions on managing brachial dissection, rare ACS diagnosis, coronary perforation, and rotablator complications. Emphasis is placed on teamwork and training illustrated by a case of acute transcatheter aortic valve migration to optimize...

Nurses and allied professionals clinical cases session

New evidence for treatment of calcified coronary artery disease

20 May 2025 – From EuroPCR 2025

Explore the latest randomized trials and studies advancing the treatment of calcified coronary artery disease. This session covers cutting balloon use, lithotripsy versus conventional preparation, and one-year outcomes comparing rotational atherectomy, lithotripsy, and laser. Also highlighted is the EMPOWER CAD study focusing on women treated with...

New evidence for treatment of calcified coronary artery disease

My approach for a calcified bifurcation lesion

20 May 2025 – From EuroPCR 2025

This session provides a comprehensive approach to managing calcified bifurcation lesions. Learn how to interpret angiographic and intravascular imaging, plan interventions with appropriate devices for simplicity and safety, and evaluate final results to understand their clinical impact through real cases.

My approach for a calcified bifurcation lesion

How imaging can help us in recognising the problem and identifying the solution?

20 May 2025 – From EuroPCR 2025

This session delves into the pivotal role of imaging in the cath lab for identifying rare and complex coronary artery conditions. Explore cases ranging from honeycomb coronary artery to acute coronary syndrome guided by intravascular imaging, and learn how reflected light and calcium changes help diagnose...

How imaging can help us in recognising the problem and identifying the solution?

How to manage the challenges of TAVI in bicuspid disease?

22 May 2025 – From EuroPCR 2025

How should TAVI be adapted to the unique challenges of bicuspid aortic valve disease? In this EuroPCR 2025 discussion, Chiara De Biase, Kentaro Hayashida, and Didier Tchetche explore the key anatomical and procedural considerations for tailoring treatment. From selecting which bicuspid anatomies are suitable for TAVI...

How to manage the challenges of TAVI in bicuspid disease?

Hotline - ACURATE neo2 under-expansion in the ACURATE IDE study: a post-hoc analysis

21 May 2025 – From EuroPCR 2025

Howard Herrmann and Raj Makkar discuss a sub-study of the ACURATE IDE trial, which examined valve under-expansion detected by fluoroscopy. Among 1,500 patients with aortic stenosis, 22 % of ACURATE neo2 valves showed under-expansion, often linked to heavy valve calcification.

Patients with under-expanded valves faced higher risks...

ACURATE neo2 under-expansion in the ACURATE IDE study: a post-hoc analysis

How to efficiently and safely manage calcified left main disease?

21 May 2025 – From EuroPCR 2025

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...

How to efficiently and safely manage calcified left main disease?

How to successfully approach calcified bifurcation lesions?

20 May 2025 – From EuroPCR 2025

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...

How to successfully approach calcified bifurcation lesions?

Calcium is not a rocket science

07 May 2025

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.

Piotr Kubler

Author

Piotr Kubler
Wojciech Zimoch

Author

Wojciech Zimoch
Wiktor Kuliczkowski

Author

Wiktor Kuliczkowski
Krzysztof Reczuch

Author

Krzysztof Reczuch
Calcium is not a rocket science

Complex PCI for severely calcified, uncrossable RCA lesion

07 Apr 2025

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...

Michal Hawranek

Author

Michal Hawranek
Lukasz Pyka

Author

Lukasz Pyka
Complex PCI for severely calcified, uncrossable RCA lesion

Rotational atherectomy, lithotripsy, or laser for calcified coronary stenosis: the ROLLER COASTR-EPIC22 trial

24 Mar 2025

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.

Ali Nazmi Calik

Reviewer

Ali Nazmi Calik

Reviewer

Aaysha Cader
Rotational atherectomy, lithotripsy, or laser for calcified coronary stenosis: the ROLLER COASTR-EPIC22 trial

How to deal with a difficult angle

20 Mar 2025

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.

María Beltrán

Author

María Beltrán
Frank Sliwinski Herrera

Author

John Frank Sliwinski
Daniele Gemma

Author

Daniele Gemma
Jorge Palazuelos

Author

Jorge Palazuelos
How to deal with a difficult angle

Impact of intravascular imaging guidance on percutaneous coronary intervention of severely calcified lesions: The ECLIPSE trial

29 Mar 2025

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

Author

Aaysha Cader
Impact of intravascular imaging guidance on percutaneous coronary intervention of severely calcified lesions: The ECLIPSE trial

Treating an “uncrossable” lesion

20 Feb 2025

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...

Ruxandra Sava

Author

Ruxandra Sava
Pietro L. Laforgia

Author

Pietro L. Laforgia
Treating an “uncrossable” lesion

Undilatable calcified lesion - LIVE case

19 Dec 2024 – From GulfPCR-GIM 2024

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...

Calcified lesions - LIVE case

“Big and heavy” – TAVI in a severely calcified aortic stenosis with large annulus

22 Nov 2024

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...

Niklas Schofer

Author

Niklas Schofer
“Big and heavy” – TAVI in a severely calcified aortic stenosis with large annulus

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!