Impella-Supported Optical Coherence Tomography-Guided Aggressive Rotational Atherectomy for Heavily Calcified Lesions in Left Main Trunk Bifurcation in a Patient with Severe Left Ventricular Systolic Dysfunction

Figure 1

Coronary angiography and PCI of RCA. Coronary angiography revealed severe stenosis with heavy calcification in the proximal and middle portions of the RCA (a) and in the bifurcation of the LMT (b–d). The calcified lesion could not be dilated with a 2.0-mm semi-compliant balloon (e) and was successfully dilated with a 2.0-mm Scoreflex™ scoring balloon (f), followed by implanting with 3.5-mm × 28-mm and 4.0-mm × 28-mm sirolimus-eluting stent of Ultimaster Tansei™ (g and h), successfully resulting in good dilatation (i).

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