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Background: Heavily calcified coronary artery disease (CAD) represents one of the most technically demanding challenges in interventional cardiology, as calcium deposits limit appropriate lesion preparation and adequate stent expansion.
Case Presentation: We report the case of a 56-year-old male with double-vessel disease involving critical stenosis of the proximal left anterior descending artery (LAD) and mid-to-distal right coronary artery (RCA). Percutaneous coronary intervention (PCI) was performed under dual-modality intravascular imaging guidance using the Makoto near-infrared spectroscopy and intravascular ultrasound (NIRS-IVUS) system. Intravascular lithotripsy (IVL) was employed for calcium modification prior to drug-eluting stent (DES) deployment.
Results: NIRS-IVUS revealed circumferential calcium arcs up to 360° in the proximal LAD with concealed lipid-rich plaque [maxLCBI₄mm = 788], and a mixed calcific-fibrotic lesion in the mid-RCA [maxLCBI₄mm = 249]. Following IVL and DES deployment, post-intervention imaging demonstrated a minimal stent area (MSA) of 5.6 mm² in the LAD and 3.6–5.3 mm² across RCA segments, with LCBI₄mm scores reduced to 486 and 106, respectively.
Conclusion: This case underscores the complementary value of NIRS-IVUS imaging and IVL-assisted lesion preparation in achieving optimal stent outcomes in complex calcific coronary lesions. The detection of lipid-rich plaque concealed beneath calcium using NIRS provided clinical insights that IVUS alone could not offer.
"Role of Intravascular Imaging and Intravascular Lithotripsy in the Management of Complex Calcific Coronary Lesions: A Case Report", International Journal for Research Trends and Innovation (www.ijrti.org), ISSN:2456-3315, Vol.11, Issue 5, page no.b610-b613, May-2026, Available :http://www.ijrti.org/papers/IJRTI2605168.pdf
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2456-3315 | IMPACT FACTOR: 8.14 Calculated By Google Scholar| ESTD YEAR: 2016
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 8.14 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator