Interventions in severely calcified coronary stenoses: lithotripsy or rotablation

    Authors

    Keywords

    calcium, coronary artery disease, rotablation, intravascular lithotripsy

    DOI

    https://doi.org/10.15836/ccar2023.66

    Full Text

    Severely calcified coronary lesions represent up to 30-40% of all coronary stenoses, and bring greater risk of complications and recurrent events. Materials like non-compliant balloon, scoring and super-high pressure balloons, together with debulking devices (rotablation and intravascular lithotripsy) are essential in calcium management. Despite the availability of several plaque modification devices, their rates of use remain low despite the prevalence of the coronary artery calcium encountered in clinical practice. ( 1 , 2 ) Percutaneous coronary intervention (PCI) in a severely calcified coronary artery is often complex and requires knowledge of materials and methods. Patients with severely calcified lesions are older, more fragile and with more comorbidities and have a harder time tolerating more complex procedures. It is important to understand how each device can be utilized in clinical practice to improve outcomes after PCI. We will present the problems encountered during PCI in severely calcified coronary artery stenoses. We will refer to the guidelines, methods and algorithm of procedures when using rotablation and intravascular lithotripsy in our Cath Lab.

    Cardiologia Croatica
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    Interventions in severely calcified coronary stenoses: lithotripsy or rotablation

    Extended Abstract
    Issue3-4
    Published
    Pages66
    PDF via DOIhttps://doi.org/10.15836/ccar2023.66
    calcium
    coronary artery disease
    rotablation
    intravascular lithotripsy

    Authors

    Matija Vrbanić*ORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Kristijana RadićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ljiljana ŠvađumovićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Vlatka FundukORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Darko NavojORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Biljana ŠegoORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Zoran MarićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Marina BudetićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Mirela AdamovićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ivica BenkoORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Irzal HadžibegovićORCIDUniversity Hospital Dubrava, Zagreb, Croatia

    Full Text

    Severely calcified coronary lesions represent up to 30-40% of all coronary stenoses, and bring greater risk of complications and recurrent events. Materials like non-compliant balloon, scoring and super-high pressure balloons, together with debulking devices (rotablation and intravascular lithotripsy) are essential in calcium management. Despite the availability of several plaque modification devices, their rates of use remain low despite the prevalence of the coronary artery calcium encountered in clinical practice. ( 1 , 2 ) Percutaneous coronary intervention (PCI) in a severely calcified coronary artery is often complex and requires knowledge of materials and methods. Patients with severely calcified lesions are older, more fragile and with more comorbidities and have a harder time tolerating more complex procedures. It is important to understand how each device can be utilized in clinical practice to improve outcomes after PCI. We will present the problems encountered during PCI in severely calcified coronary artery stenoses. We will refer to the guidelines, methods and algorithm of procedures when using rotablation and intravascular lithotripsy in our Cath Lab.