Calcium: The Achilles Heel of Endovascular Procedures?

How does calcium influence your treatment strategy? A short presentation regarding the impact of calcium in the treatment of femoropopliteal disease and a proposed algorithm for the use of scaffolds or ‘leave-nothing-behind’ strategies for severely calcified lesions.


    Thanks for sharing this excellent presentation Dr Stavroulakis. Calcium is a challenge.
    I agree with your algorithm showed at the lasts slides, for long CTO, in old patients, about the recommendation of the need of stents. In my humble opinion, and even if I am also a believer of the “don’t live nothing behind concepts”, my personal experience is that in this more 15 length CTO, many times recanalized subintimal I don’t achieve a great vessel preparation , and recoil is there after DEB, also many non limítanos flow dissection, so my option is to leave a BMS, or covered stent, or DES there if not used DEB.
    I also agree that for young patients, claudicants, atherectomy devices + vessel preparation and DEB should be the first strategy and yes, avoid stent in patients with large expectancy of live.
    Best regards.

    MD Konstantinos Stavroulakis
    February 2, 2019

    Thanks Fernando! I have to admit that this algorithm might have to be modified again, depending on the ongoing PTX discussion.

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