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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Bifurcation with provisional stent strategy - LIVE case

17 May 2023 – From EuroPCR 2023

Learn more about a 65-year-old diabetic male patient with BMI 31, NYHA III shortness of breath, and a mid-calcified lesion on proximal and mid-part of LAD. QFR and µFR were significant for the 2 LAD lesions (0.73 and 0.74). The proximal lesion was a bifurcation Medina 1-0-1...

Bifurcation with provisional stent strategy - LIVE case

Complex bifurcation PCI - LIVE case

17 May 2023 – From EuroPCR 2023

Study the case of this 69-year-old male patient with recent PCI on LAD presenting chronic coronary syndrome. Angiography showed calcified stenosis on bifurcation of proximal CX and large obtuse marginal 1, Medina 0-1-1.

The PCI strategy was an OCT-guided TAP technique: 

7F guiding catheter, predilatation with semi-compliant and non-compliant...

Complex bifurcation PCI - LIVE case

New developments in intravascular lithotripsy after 5 years of clinical practice

17 May 2023 – From EuroPCR 2023

Angela McInerney and James Spratt look back at 5 years of intravascular lithotripsy and how it has evolved from its beginnings to the present day.  

Calcium has always been a very complex issue especially in older patients, but the tools to treat it were somewhat limited....

New developments in intravascular

Our patient with a highly calcified vessel

15 May 2023 – From EAPCI-PCR Fellows course 2023

Consult these slides to define a step-by-step strategy to deal with calcified lesions, discover how OCT can support your decision making and to learn how to learn how to use ROTABLATOR for an effective and safe plaque debulking.

Our patient with a highly calcified vessel

How should I treat? – TAVI with a self-expanding aortic valve in bicuspid aortic valve stenosis

09 Mar 2023

A 73-year-old male patient was referred for treatment of severe symptomatic aortic valve stenosis. This case describes the decision-making in performing TAVI with a self-expanding aortic valve in a patient with bicuspid aortic valve stenosis and peripheral arterial disease.

Author

Ole De Backer
Lars Sondergaard

Author

Lars Sondergaard
How should I treat? – TAVI with a self-expanding aortic valve in bicuspid aortic valve stenosis

Successful rotablation of a calcium spike blocking the motion of a mechanical prosthetic leaflet

27 Mar 2023

Thanks to this EIJ image, consider the case of a 46-year-old female patient who underwent a first aortic valve replacement at the age of 25, a second one 10 years later, together with a mitral valve replacement, and who presented with a displaced calcium spike from...

Successful rotablation of a calcium spike blocking the motion of a mechanical prosthetic leaflet

Calcified left main bifurcation PCI: how to evaluate and how best to treat - LIVE case

04 Mar 2023 – From AfricaPCR 2023

A 62-year-old male with hormonal treatment (metastatic prostate carcinoma) presents an exertion angina due to an MVD: severe calcified stenoses of distal left main (medina 1-1-1), mid LAD and prox CX.
Watch how the operators prepare LAD and CX lesions with Rotablator (Burrs: 1.25 + 1.75) then...

Calcified left main bifurcation PCI

How should I treat a calcified lesion - A patient's journey

03 Mar 2023 – From AfricaPCR 2023

In this session, follow the discussion about a 76-year-old male patient with HTN, type 2 DM, dyslipidaemia and progressive angina who presented with a preserved LVEF without RWMA and a positive treadmill exercise test... 

How should I treat a calcified lesion

TAVI in a patient with heavily calcified valve anatomy - LIVE case

18 Feb 2023 – From PCR Tokyo Valves 2023

An 80-year-old male with chronic kidney disease and interstitial pneumonia treated under steroids presented a symptomatic severe aortic stenosis with massive calcifications on the valves and only on the valves (not the LVOT).
Watch the operators implant a Sapien 3 23 mm (-1cc) with a predilatation (Balloon...

TAVI in a patient with heavily calcified valve anatomy

High-speed rotational atherectomy versus modified balloons for plaque preparation of severely calcified coronary lesions: two-year outcomes of the randomised PREPARE-CALC trial

17 Jan 2023

The PREPARE-CALC trial was the first trial that compared lesion preparation using rotational atherectomy (RA) prior to sirolimus-eluting stent (SES) implantation with modified balloons (MB; cutting or scoring) in patients presenting with chronic coronary syndromes.

Ali Nazmi Calik

Reviewer

Ali Nazmi Calik
Ismail Polat Canbolat

Reviewer

Ismail Polat Canbolat
High-speed rotational atherectomy versus modified balloons for plaque preparation of severely calcified coronary lesions: two-year outcomes of the randomised PREPARE-CALC trial

Another frontier crossed!

15 Dec 2022 – From GulfPCR-GIM 2022

Watch this session to find out more about the optimal approach to complex patients, to learn about optimal plaque modification techniques, including atherectomy, to discuss the approach to severely calcified lesions, and to know more about the added value of intravascular imaging.

Another frontier crossed!

The why and how of performing plaque modification in calcified lesions

15 Dec 2022 – From GulfPCR-GIM 2022

Consult this session to learn more about the different kinds of lesions we face during coronary angiography and the different tools and techniques available to treat calcified lesions, as well as to discover how to prepare for each procedure to treat calcified lesion and how to manage complications.

The why and how of performing plaque modification in calcified lesions

Challenging and complication cases

14 Dec 2022 – From GulfPCR-GIM 2022

Among the 5 cases presented in this GulfPCR-GIM 2022 session, learn more about post aortic valve replacement complications, complex bicuspid TAVI, or primary PCI for re-implanted left main trunk post aortic root replacement, among others!

Challenging and complication cases

Cracking calcium: intravascular lithotripsy’s unique mode of action in treating calcified lesions – What's the evidence?

14 Dec 2022 – From GulfPCR-GIM 2022

Watch this GulfPCR-GIM 2022 session to understand the unique mechanism of action of IVL, the use of intravascular imaging in calcium identification, the gender gap, disrupted CAD trials, and the evolution of treatment of calcified lesions together with the role of IVL.

Cracking calcium: intravascular lithotripsy’s unique mode of action in treating calcified lesions – What's the evidence?

Optimal PCI in patient with long calcified lesion

14 Dec 2022 – From GulfPCR-GIM 2022

In this session, follow a LIVE case from the Chest Diseases Hospital in Kuwait and learn what the best strategy is to treat patients who present with a very long calcified coronary artery lesion, as well as how to select the best device and which different...

Optimal PCI in patient

IVUS post-rotablator: the older the calcium, the newer the treatment

31 Jan 2023

How would you treat a 90-year-old female patient with HTN, dyslipidaemia, paroxysmal AF, CCS and CKD, whose stable angina CCS II has been worsening for a few months and whose angio reveals severe calcified stenosis of the proximal and middle LAD? 

Dario Tino Bertolone

Author

Dario Tino Bertolone
Marta Belmonte

Author

Marta Belmonte

Author

Jeroen Sonck
IVUS post-rotablator: the older the calcium, the newer the treatment

Mitral valve in mitral annular calcification (MAC) - Recorded case

27 Nov 2022 – From PCR London Valves 2022

A 53-year-old male with a history of SAVR (Perimount 23) 10 years ago and chest radiotherapy (lymphoma) presents a severe mitral stenosis (MAC) with preserved LV function and impaired RV function.
On sentinel cerebral protection, the operators perform a transseptal puncture with electrifying a non-stiff guide wire,...

Recorded case: Mitral valve in MAC

A patient with a high-bleeding risk – how should I treat a calcified lesion?

31 Oct 2022

Discover the replay of this PCR Webinar on the Road and continue your world tour with a trip to Aalst, Belgium with E. Barbato, C. De Biase and D. Milasinovic

A patient with a high-bleeding risk – how should I treat a calcified lesion?

Porcelain aorta, calcified aortic valve, and calcified left main: what comes first, the valve or the artery?

08 Nov 2022

How would you treat this 76-year-old male patient with severe AS symptomatic for angina, sinus rhythm with RBBB, previous bilateral CEA, and total occlusion of both the left CCA and the subclavian?

Author

Flavio Luciano Ribichini
Petros Dardas

Author

Petros Dardas
Beatriz Vaquerizo

Author

Beatriz Vaquerizo
Porcelain aorta, calcified aortic valve, and calcified left main: what comes first, the valve or the artery?

How to deal with calcified coronaries

08 Oct 2022 – From AICT-AsiaPCR 2022

In this session, learn with experts about practical decisional algorithms to select the most appropriate tool in function of calcification severity and extension, and discover the contemporary tools and techniques for optimal plaque modification.

How to deal with calcified coronaries