ABSTRACT
Calcified vessels and lesions form a very challenging subgroup of complex lesions faced in the real world practice. Calcified lesions are more likely to have stent thrombosis and restenosis. It is conceivable that a strategy of decalcifying long diffuse calcified lesions by rotational atherectomy (RA) followed by multiple BRS implantations could improve outcomes in the difficult subgroup of patients. This chapter presents some procedural principles of techniques of percutaneous coronary intervention (PCI) using BRS for calcified lesion that need emphasis to achieve the best results. BRS can be safely used to treat calcified coronary arteries with favorable immediate and short-term outcomes. This requires understanding the procedural tips and tricks to achieve delivery success, and it requires aggressive and adequate lesion preparation using high pressure predilatation with noncompliant (NC) balloons/scoring or cutting balloons. The potential advantage of BRS for long diffuse calcified disease would need to be proven.
