Complex Case Review: Treating Massive Nodule of the Left Main with Shockwave IVL

Описание: Massive Nodule of the Left Main: Did Shockwave IVL Work? | Complex Calcium Case Review

In this captivating case review, Dr. Chris Brown teams up with Dr. Yousif Ahmad, Director of the Complex Coronary Program at UCSF, to break down an extremely challenging case involving a giant calcific nodule at the left main bifurcation — potentially linked to a previously placed Amulet device.
They dive into key decision points:
• Should this have been treated with atherectomy?
• What role did IVL (Shockwave) play in modifying this massive nodule?
• Can nodular calcium be influenced by LAA closure devices over time?

This case covers:
✅ Imaging tips for identifying nodular calcium
✅ When and how to use lithotripsy vs atherectomy
✅ Deliverability tricks with Takaru balloons
✅ Managing eccentric calcium and imperfect stent expansion
✅ A deep dive into procedural strategy, device selection, and long-term implications

If you treat calcified coronary lesions, especially nodular ones, this conversation offers essential pearls you won’t want to miss.

Chapters:

00:00 – Intro & Case Overview (NSTEMI + Amulet Anatomy)
01:29 – Identifying the Massive Nodule
03:07 – IVUS Challenges & Takaru Balloon Strategy
04:58 – IVL for Nodular Calcium: Does It Work?
07:02 – Expansion, Stenting, and Anchor Balloon Considerations
10:01 – Navigating Unusual Anatomy and Final Result
14:24 – Amulet Device Link to Calcium?
17:26 – Key Lessons on Nodules & Device Strategy
20:02 – Wrap-up & Takeaways

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#IVL #Calcium #Nodule #Shockwave #Atherectomy #LAA #InterventionalCardiology #MurmurMD #StentOptimization #ComplexPCI