Ep. 5 Calcium Modification in Coronary Artery Disease: IVL or Atherectomy? with Dr. Yader Sandoval

Calcium belongs in the bones, not the blood vessels! But once it’s there, how can interventional cardiologists use their skills and tools to combat it? In this episode of the BackTable Cardiology Podcast, host Dr. Hady Lichaa interviews Dr. Yader Sandoval from the Minneapolis Heart Institute about handling coronary calcification. --- SYNPOSIS Dr. Sandoval shares insights into the challenges of treating calcified coronary lesions, the importance of intravascular imaging, and his strategic approach to using technologies like intravascular lithotripsy, atherectomy, and specialty balloons. He emphasizes practical tips and tricks for interventional cardiologists to optimize procedure outcomes and tackle severe coronary calcification effectively. Their discussion overviews the latest innovations in the field, providing valuable advice for balancing advanced techniques with procedural efficiency. Dr. Sandoval also details the where, when, and how of approaching in-stent restenosis (ISR), including how to use imaging to optimize treating heavy calcifications around stents. --- TIMESTAMPS 00:00 - Introduction01:57 - Overview of Coronary Calcification08:08 - Severe Calcification Cases: Equipment and Technique21:08 - Guide Wires, Microcatheters, and Guide Extensions for Calcified Lesions31:24 - IVUS vs OCT36:21 - Atherectomy vs IVL Considerations43:32 - Calcified Nodules 51:06 - Stents and In-Stent Restenosis Management56:42 - Conclusion --- RESOURCES Dr. Yader Sandovalhttps://mplsheart.org/yader-sandoval-md Abbott Northwestern Hospital Dr. Hady Lichaahttps://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa SCAI Expert Consensus Statement on Management of In-Stent Restenosis and Stent Thrombosishttps://pmc.ncbi.nlm.nih.gov/articles/PMC11308135/