Heavily calcified critical type C LAD lesion (Rota/ IVL/ OCT) by Tejas Patel and Sanjay Shah

The third case was done by me along with Sanjay. It was again a case of heavily calcified critical type C LAD lesion. There was 360-degree loop in the right subclavian artery. We demonstrated the technique of going through the loop and cannulating the LMCA. We used 1.5 mm burr to do rotational atherectomy. After giving at least 4 passes at the speed of 1,50,000 rpm. The lesion was not crossed. There was a lot of discussion regarding various strategies. Then we went up to 1,80,000 rpm to cross the lesion. After that, we gave all the 80 pulses of Shockwave followed by balloon dilatation and stenting to achieve an excellent MSA. It was confirmed by OCT evaluation. It was a long live demonstration, but everybody enjoyed it.