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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IMPELLA protected PCI and intravascular lithotripsy in a calcified degenerated saphenous vein graft

27 Jan 2022

Find out more about a 77-year-old male patient with hypertension without good BP control, dyslipidaemia, Type II-DM, ex-smoker, who had triple CABG in 2006, EF 60% in 2017, and presented with dyspnea. 

Author

Flavio Luciano Ribichini
Gabriele Pesarini

Author

Gabriele Pesarini
IMPELLA protected PCI and intravascular lithotripsy in a calcified degenerated saphenous vein graft

How should I treat? - TAVI in small anatomy with significant LVOT calcification

20 Jan 2022

An 89-year-old man was referred for treatment of severe symptomatic aortic stenosis. This case describes the decision-making in performing TAVI in a patient with twin challenges of small annulus and significant LVOT calcification.

Author

Dan Blackman
Cunnington Michael

Author

Cunnington Michael
Chris Malkin

Author

Christopher Malkin
How should I treat? - TAVI in small anatomy with significant LVOT calcification

Approach to calcified lesions and role of plaque modification and intravascular imaging to obtain optimal PCI - Session with LIVE case

15 Dec 2021 – From GulfPCR-GIM 2021

Watch the case of a 55-year-old male patient who is a diabetic on insulin and hypotensive, who initially presented with NSTEMI and 3-vessel disease but declined CABG before being readmitted with unstable angina.

Approach to calcified lesions and role of plaque modification and intravascular imaging to obtain optimal PCI

How to use devices efficiently in calcified lesions

15 Dec 2021 – From GulfPCR-GIM 2021

This case-based and practical guidance session will enable you to know how to tailor the available technology for lesions with high calcium content, understand the limitations of each device used for plaque modification, and overcome difficulties with each modality.

How to use devices efficiently

Challenging routes for TAVI

21 Nov 2021 – From PCR London Valves 2021

Watch this PCR London Valves 2021 session to look at transfemoral TAVR in patient with severe stenosis of iliac artery, to appreciate a transfemoral aortic valve replacement in a patient affected by abdomen aorta barrage, and more!

Challenging routes for TAVI

Calcified lesions: how to deal with it?

09 Oct 2021 – From AICT-AsiaPCR 2021

Watch this session to learn how to use intravascular imaging to assess calcified stenoses and how to select the right device for their treatment, as well as to discover more about the management of complications related to rotational atherectomy.

Calcified lesions: how to deal with it?

Left main bifurcation with DK crush technique

09 Oct 2021 – From AICT-AsiaPCR 2021

Don't miss this session from AICT-AsiaPCR 2021 if you wish to understand how imaging can help in strategising the PCI procedure in a calcified vessel, or to be familiar with how to perform bifurcation PCI of left main and LAD/D1 with two-stent technique, among others!

Left main bifurcation

The challenges of complex PCI treatment: mechanical support in CHIP patients and IVL for calcified coronary disease

09 Oct 2021 – From AICT-AsiaPCR 2021

Discover the secrets of lithotripsy with this dedicated session that presents the latest results from DISRUPT CAD pooled analysis and real-world clinical data, and learn, among others, how to optimally adopt Intravascular Lithotripsy (IVL) for treatment of calcified lesions.

The challenges of complex

Cases on calcified lesions

08 Oct 2021 – From AICT AsiaPCR 2021

Watch this session to discover various interesting cases on calcified lesions, such as a spiral coronary dissection due to intravascular balloon lithotripsy rupture, a CHIP case of recalcitrant coronary calcium, and more!

Cases on calcified lesions

Complications: calcified LM-LAD PCI, CHIP and TAVI

08 Oct 2021 – From AICT-AsiaPCR 2021

Watch this session on complications to see 3 clinical cases: "calcified LM-LAD PCI with rotablator", "cascading events in a CHIP case" and "complications in TAVI", and discover how they managed to face them. 

Complications: calcified

Treating complex coronary lesions: right case right time Prevail™ DCB

01 Oct 2021 – From AICT-AsiaPCR 2021

Thanks to this session, find out more about indications for drug-coated balloons, or, on the contrary, learn when not to use it. And through the analysis of two concrete cases, see how DCB can be an important tool to tackle increasingly complex patients and anatomies, especially...

Treating complex coronary lesions: right case right time Prevail™ DCB

Telescope guide extension catheter in complex coronary interventions

01 Oct 2021 – From AICT-AsiaPCR 2021

View the complex case of this 70-year-old male patient with hypertension and diabetes who presented with chest pain and NSTEMI, which shows that, when dealing with challenging calcific disease, guide catheter extensions help improve device delivery.

Telescope guide extension

How should I treat a fractured microcatheter?

16 Sep 2021

A 80-year old man presented to hospital with an anterior non-ST segment elevation myocardial infarction and acute pulmonary edema... This case describes  a fractured microcatheters in calcific coronary arteries/chronic total occlusions.

Vinayak Nagaraja, Interventional Cardiologist

Author

Vinayak Nagaraja
Dr Jaikirshan J. Khatri

Author

Jaikirshan J. Khatri
How should I treat a fractured microcatheter?

CABG or PCI?

05 Oct 2021

Find out more about the case of a 72-year-old male, very active, previous smoker with hypertension, who underwent a stress echo for dyspnea on exertion...

Reviewers:

Michele Pighi et Flavio Luciano Ribichini

Prof. Thomas Cuisset

Author

Thomas Cuisset
Pierre Deharo

Author

Pierre Deharo

Author

Jérôme Ferrara
CABG or PCI? Heart team and patient decision

A Medina 1-1-1 unprotected LM bifurcation in a transplanted heart

10 Aug 2021

Find out more about the case of a 70-year-old male with previous heart transplantation at 48 yo due to IHD, claudication of the right leg, and PTA of iliac arteries...

M. Pighi

Author

Michele Pighi

Author

Flavio Luciano Ribichini
Medina 1-1-1 unprotected LM bifurcation in a transplanted heart

Operator volumes and in-hospital outcomes: an analysis of 7,740 rotational atherectomy procedures from the BCIS national database

05 Jul 2021

Find out more about the results of this analysis which suggest that operator experience may be an important effect modifier in ROTA-PCI.

Nicola Ryan

Reviewer

Nicola Ryan
Operator volumes and in-hospital outcomes: an analysis of 7,740 rotational atherectomy procedures from the BCIS national database

Complications in complex rotational atherectomy

This session will help you get prepared if you have to become familiar with a novel way to release stuck rotational atherectomy burr, deal with severely calcified RCA including removal of a stuck Rotablator, or cope when Rotablator burr catheter entraps.

EuroPCR 2021 Complications in complex rotational atherectomy

How to solve rotational atherectomy burr entrapment with a guide extension catheter in 4 steps

21 Jun 2021

In this article, the authors describe (with video illustration) the step-by-step technique for resolution of an entrapped RA burr using a guide-catheter extension...

Rodrigo Vugman Wainstein

Author

Rodrigo Vugman Wainstein
Luiz Carlos Bergoli

Author

Luiz Carlos Bergoli
Sandro Cadaval Gonçalves

Author

Sandro Cadaval Gonçalves
Prof. Marco V. Wainstein

Author

Marco Wainstein
How to solve rotational atherectomy burr entrapment with a guide extension catheter in 4 steps

A step-by-step protected high-risk PCI with the Impella CP

06 Jul 2021

Find out more about the case of an 85-year-old male with dyslipidemia, former smoker with previous cardiovascular events, symptomatic for worsening epigastric pain and shortness of breath...

Gabriele Pesarini

Author

Gabriele Pesarini

Author

Flavio Luciano Ribichini
A step-by-step protected high-risk PCI with the Impella CP

Clinical applications of IVUS, OCT and other intracoronary imaging techniques: practical simulation-based learning (Part 1)

19 May 2021 – From EuroPCR 2021

The aim of this session, originally presented during EuroPCR 2021, is to demonstrate how intra-coronary imaging can improve outcomes, to help understand appropriate indications for its use, and to provide practical tips & tricks on how to integrate intra-coronary imaging into daily clinical practice through a...

Clinical applications of IVUS, OCT and other intracoronary imaging techniques: practical simulation-based learning (Part 1)