Complex PCI: Nothing Is Simple in Shock Patients!-Chipping Away: Calcium Modification in Complex PCI, Dr. Saraschandra Vallabhajosyula

Chipping Away: Calcium Modification in Complex PCI, Dr. Saraschandra Vallabhajosyula

Video Transcription

Video Summary

Dr. Saras Vallabhajosla discussed complexities in high-risk PCI, emphasizing the importance of calcium modification in severely calcified coronary lesions common in sicker patients. He highlighted intravascular imaging (IVUS/OCT) as essential for assessing calcification and guiding intervention. Various calcium modification tools include rotational/orbital atherectomy, intravascular lithotripsy (IVL), and laser atherectomy, each with pros and cons depending on lesion characteristics and vessel anatomy. Recent trials show comparable efficacy among these devices, with IVL being easier to operate and safer. He stressed flexibility, imaging guidance, and operator judgment for optimal outcomes, especially in patients with shock or mechanical circulatory support.

Keywords

high-risk PCI

calcium modification

intravascular imaging

rotational/orbital atherectomy

intravascular lithotripsy