Interventional Cardiology / Clinical Data / Optimal Therapies

The right tools for calcium treatment.

We offer the most advanced and complete Modern PCI solutions
to master all types of coronary calcific lesions.

Optimal Therapies

Learn more about Calcified CAD and Optimal Therapies.

When it comes to identifying and treating calcific lesions, using the right tools makes all the difference. But many go-to strategies fall short, and can lead to compounding challenges.

Calcific Lesion Modification Strategy

Optimal patient outcomes come from a systemic three-step approach to treat calcific lesions.

See with IVUS
Assess lesion length, plaque morphology and vessel size
Prep the lesion, appropriately modify the calcium with cutting balloon (<180°), rotational atherectomy (>270°) or intravascular lithotripsy (>270°)

Diagnose with IVUS

You can't treat what you can't see. Angiography is only effective at identifying the most severe cases of Calcific CAD. In fact, only 38% of cases show visible calcium via angiography¹. Since low to moderately calcific lesions can still act as a considerable barrier to an optimal outcome, you'll need to use IVUS for every procedure.

Angiography, for example, is successful at identifying calcium in only 38% of cases – essentially only effective in the most severe cases.

IVUS is the preferred option for effectively visualizing and identifying calcium, no matter the severity, allowing you to make better treatment decisions with confidence. In fact, the use of IVUS has been shown to change treatment decisions 74% of the time.¹

In fact, the use of IVUS has been shown to change treatment decisions 74% of the time.

IVUS is necessary for every procedure

- Enables better identification of the lesion type
- Allows for better treatment decisions

Mastering Imaging

Prepare and Treat with the right tools for calcium

Identification is not the only area in which the status quo has failed to keep pace with your needs. POBA, a commonly used solution for addressing these lesions, can lead to dissections or perforations, leading to longer case time and limiting options for completing the case.

Rotational Atherectomy and Cutting Balloon treatment have proven efficacy for each level of calcification. Rotational Atherectomy is known to deliver exceptional outcomes, with multiple studies indicating that Rotational atherectomy results in high procedural success rates with acceptable short- and longer-term MACE rates considering the severity of patient and lesion characteristics.

In the recent DIRO study, a head to head comparison of orbital versus rotational atherectomy, rotational atherectomy (RA) demonstrated its superiority in treating calcified coronary lesions by achieving a larger maximum plaque modification area of 1.24 mm2 compared to orbital atherectomy at 0.89 mm2 (p<0.01)³. These findings prove the potential of RA for improved patient outcomes in managing calcified lesions.

To dive deeper into these insights, download our one-page overview of the DIRO study.

Cutting Balloon has proven successful in treating calcific lesions in the recent COPS study.

Calcium is being severely undertreated:

Atherectomy is only used in 1-2% of PCI cases

An estimated 88% of identified calcium is left untreated.

The COPS study, a prospective, multicenter, randomized controlled trial, has recently shed light on the efficacy and safety of using a cutting balloon (CB) for the treatment calcified lesions.

Three key takeaways from the COPS study are:

Using a high-pressure CB results in a larger MSA (minimal stent area) and lower eccentricity of the stent at the level of the calcified segments compared to NCB (noncompliant balloon) angioplasty.⁵
CB is safe compared to NCB angioplasty.⁵
Using a CB instead of NCB optimizes lesion preparation in the case of significant calcifications (>270°).⁵

Interested in learning more?