Representative images of lesion preparations with the (A) balloon-and (B) ablation-based techniques. (A-1) Angiography revealed stenosis with severe calcification (arrows in A-1') in the mid left anterior descending artery (LAD). The boxed area in A-1 is shown magnified in A-1' without contrast. (A-2) Pre-percutaneous coronary intervention (PCI) optical coherence tomography (OCT) cross-sectional image showing severe near-circumferential calcification in the target lesion. (A-3) After lesion preparation with a modified balloon (A-3'), retrograde Type C coronary dissection (arrows) with flow limitation occurred, originating from the balloon dilatation site to the proximal LAD. (A-4) Post-lesion preparation OCT cross-sectional image detected a large coronary dissection (double-headed arrow) involving the media, and the calcium plaque remained unscathed. (A-5) Coronary flow was restored with 2 drug-eluting stents sealing the entire dissected segment. (A-6) Post-PCI OCT cross-sectional image showing asymmetrical stent expansion in the direction opposite to the calcium plaque. (B-1) Angiography showed stenosis with severe calcification (arrows in B-1') in the mid LAD. (B-2) Pre-lesion preparation OCT cross-sectional image showing severe near-circumferential calcification in the target lesion. The boxed area in B-1 is shown magnified in B-1' without contrast. (B-3) Rotational atherectomy (RA) with a 2.0-mm burr was performed, followed by modified balloon dilatation (B-3'). (B-4) Post-lesion preparation OCT cross-sectional image showing a calcified plaque with a smooth concave surface ablated by RA (arrowheads). (B-5) Treatment of the target lesion was finished with a drug-coated balloon, and the lesion was opened wide without severe dissection. (B-6) Post-PCI OCT crosssectional image showing multiple calcium fractures (arrows); the maximum thickness of the calcium fracture was 1,000 μm.

Contexts in source publication

Context 1

... Preparation by Atherectomy technique in 62 (balloon group) and with the ablationbased technique in 59 (atherectomy group). Representative images of lesion preparations in the balloon and atherectomy groups are shown in Figure 1. Patient and angiographic lesion characteristics are presented in Table 1. ...

Context 2

... Preparation by Atherectomy technique in 62 (balloon group) and with the ablationbased technique in 59 (atherectomy group). Representative images of lesion preparations in the balloon and atherectomy groups are shown in Figure 1. Patient and angiographic lesion characteristics are presented in Table 1. ...