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Real cases and insights: expert reviews
As PCI continues to evolve, effective lesion preparation remains critical to procedural success. School of Rock offers on-demand expert guidance, case-based learning, and practical education focused on coronary calcium management - helping you confidently select theright strategy for each lesion.
Importance of lesion prep
Part 1: The Challenge
Is calcium turning your complex PCI cases into high-stakes challenges? Dr. Angela Taylor and Dr. Salman Arain tackle the alarming prevalence of calcified lesions, discussing the preventable drivers of worse patient outcomes and sharing a simple way to address the issue.
Part 2: Angiography Alone is Insufficient
The message is simple: if you’re not using IVUS, you’re not seeing the full picture. See how angiography alone often falls short. Examine real examples of calcium lesions with IVUS and hear what three major trials—IVUS-XPL, ULTIMATE, and RENOVATE—prove intravascular imaging’s impact on outcomes.
Part 3: IVUS Basics
Master the basics of Intravascular Ultrasound (IVUS). Understand what calcium looks like on ultrasound, easily differentiate calcium on screen. Learn to avoid mistakes and improve outcomes by accurately assessing your lesion.
Part 4: Post-Prep IVUS Assessment
Once we’ve treated a vessel, how do we assess it? Hear physicians discuss an IVUS scoring system that can help assess lesion modification and predict/ensure better stent placement and patient outcomes.
Part 5: SCAI Guidance on PCI Calcium Treatment
Get up to speed on the latest in calcium management! This video details the SCAI Consensus Statement, focusing on its innovative point system for assessing calcium lesions with Intravascular Ultrasound (IVUS).
Part 6: A Calcium Algorithm
"If you can't get that IVUS catheter down, don't even think about stenting." This is just one of many vital tips from expert operators Dr. Arain and Dr. Taylor. Join them as they reveal a high-level strategy for calcium lesion modification, sharing essential tips to navigate your most challenging PCI cases.
Prep the vessel for PCI success
Proper lesion preparation is critical for achieving optimal outcomes and preventing restenosis. To ensure success, your toolkit should be tailored to handle the diverse characteristics of each lesion.
Lesion prep treatment strategies for complex cases
Effective lesion preparation is crucial for optimal outcomes. Learn how to assess calcified coronary lesions and select the right lesion modification strategy with a step-by-step, IVUS-guided approach.
IVUS 123 workflows
See how experts use IVUS to access key calcium morphologies and leverage the IVUS 123 algorithm to guide appropriate calcium modification strategies, stent optimization, and post-stent assessment.
ROTAPRO™ Rotational Atherectomy System
Part 1: ROTAPRO System Components
Uncover the ROTAPRO™ rotational atherectomy system, starting with precise rotablation and burr activation with control. Walk through the system components and supporting accessories with Dr. Taylor and Dr. Arain.
Part 2: ROTAPRO Mechanism of Action Basics
We cover differential cutting, rotation speed, sizing basics, proper technique and the fundamental device benefits. Get expert advice about when and why these physicians use higher speeds when passing with ROTAPRO™. See real-world examples of artery tissue that has been treated with rotational atherectomy.
Part 3: ROTAPRO Use Cases
Dive deep into essential techniques for using ROTAPRO™, when to use it, and crucially what to avoid for optimal patient outcomes. Explore clinical data on ROTAPRO’s efficacy and uncover use case answers to common questions like: What is the maximum burr to artery ratio? When and where is ROTA most effective? What speeds should I operate at? What NOT to do? What is the perforation rate?
Part 4: ROTACut Combination Strategy
We explore ROTACUT Combination strategy that is a powerful lesion preparation technique that combines rotational atherectomy with cutting balloon angioplasty to optimize stent expansion.
ROTAPRO Rotational Atherectomy System certification
The ROTAPRO didactic course is one of three phases to complete for ROTAPRO certification. This training provides information on patient selection considerations, a review of clinical data, as well as technical considerations and complications management.
ROTAPRO Rotational Atherectomy System
ROTAPRO delivers unmatched plaque modification and precision, ensuring predictability and safety when navigating complex lesions.
WOLVERINE™ Cutting Balloon
Part 1: WOLVERINE Basics
A brief history and overview of the WOLVERINE cutting balloon. Device design, understanding what makes it more deliverable than older generations of cutting balloons, and what data says about when to use a cutting balloon vs. a regular balloon or different modified specialty balloon. Understand its mechanism of action and terminology you may hear in the lab. Like, what is a controlled dissection?
Part 2: WOLVERINE Stress Distribution & Stress Levels
Understand a reasonably priced solution to solving multiple calcific problems, quickly, safely, and effectively. Review peak tensile stress, the cutting balloon’s TRUE impact on vessels, what pressure looks like in a vessel on a heat map (bench study data). And bonus, a strategic approach for tackling nodular calcium. See what Dr. Arain means when he says, “cutting early and cutting often”.
Part 3: WOLVERINE Cut to the Data
Breakdown of two randomized clinical studies comparing the WOLVERINE cutting balloon to regular balloons – COPS and RESCUT. Preview: WOLVERINE use results in fewer balloons, less slippage, comparable safety, and better MSA. Hear cases/lesions in which these doctors reach regularly for a cutting balloon.
Part 4: WOLVERINE A Super Safe Device
Atherotome myths dispelled as Dr. Salman Arain presents the true atherotome size of the WOLVERINE cutting balloon, and the true rate of perforation, and learnings from past mistakes.
WOLVERINE Coronary Cutting Balloon
WOLVERINE's unique atherotome design creates micro-incisions to deliver precise, predictable and controlled lesion modification.
SEISMIQ™ 4CE Coronary Intravascular Lithotripsy Catheter
FRACTURE Physician Experience Series
FRACTURE IDE Trial Experience - Dr. Christiansen
Dr. Evald Høj Christiansen shares his perspective on the FRACTURE IDE Trial with SEISMIQ 4CE. He highlights reassuring clinical results, deliverability in complex calcified lesions, the four-emitter design, and the importance of imaging-guided calcium modification.
FRACTURE IDE Trial Experience - Dr. Baron
Dr. Suzanne Baron shares her perspective on the FRACTURE IDE Trial and her experience with SEISMIQ 4CE. She highlights the importance of clinical data and intravascular imaging in complex calcium cases, as well as the role of SEISMIQ 4CE within the calcium modification toolbox.
FRACTURE IDE Trial Experience - Dr. Pareek
Dr. Nilesh Pareek discusses key takeaways from the FRACTURE IDE Trial and his experience with SEISMIQ 4CE. He highlights the trial’s safety and effectiveness findings, real-world calcified lesion complexity, and how deliverability and emitter visibility may help physicians work more efficiently in complex cases.
FRACTURE IDE Trial Experience - Dr. Dohad
Hear from Dr. Suhail Dohad as he shares key takeaways from the FRACTURE IDE Trial and his experience with SEISMIQ 4CE. He highlights device deliverability, workflow efficiency, emitter visibility, and the importance of vessel preparation in treating complex calcified coronary lesions.
SEISMIQ 4CE Coronary Intravascular Lithotripsy Catheter
SEISMIQ 4CE (pronounced 'force') is a novel intravascular lithotripsy catheter designed for complex lesions, delivering the visibility needed for precise, targeted calcium modification.
Tying evidence to products
Driving Evidence-Based Decisions for Calcium Tx using the ShortCUT Trial
Provides a concise overview of the ShortCUT study and combines trial information and clinical outcomes with insights gathered through physician interviews and KOL feedback.
Why ShortCUT Matters
Dr. Kirtane discusses why the trial was conducted and how Wolverine may provide a cost-effective alternative to Shockwave.
Clinical Impact and Real-World Implications
Dr. Kirtane reviews the primary findings showing non-inferior imaging outcomes compared with Shockwave and minimal differences in stent expansion. He highlights the significant cost savings associated with Wolverine-based treatment strategies while maintaining comparable procedural outcomes.
Balloon-Only Results: Wolverine vs Shockwave
In patients treated without upfront atherectomy, Shockwave produced slightly larger measured areas, but the differences became clinically negligible after vessel size adjustment. The overall conclusion is that Wolverine delivers effective calcium modification at substantially lower procedural cost.
Inside the ShortCUT Trial Design
This video explains the study's randomized, imaging-guided design and the rationale for evaluating both atherectomy and non-atherectomy treatment pathways. The design allowed investigators to independently compare Wolverine and Shockwave across different clinical scenarios and calcium severities.
Building the Right Calcium Toolbox
Dr. Kirtane discusses how ShortCUT reinforces a tailored approach to calcium treatment. Rather than positioning technologies as competitors, he describes Wolverine, atherectomy, and Shockwave as complementary tools that deliver the best outcomes when selected appropriately and guided by imaging.
Why the ShortCUT Trial Was Needed
Dr. Baron explains why the ShortCUT trial was conducted and why coronary calcium remains a growing challenge in PCI.
The Two-Cohort Trial Design Explained
Dr. Baron gives an overview of the innovative two-cohort trial design comparing balloon-only and atherectomy-assisted strategies.
The High-Pressure Wolverine Strategy
Dr. Baron gives the rationale behind high-pressure, downsized Wolverine therapy and the evidence supporting the approach.
Primary Trial Results
Dr. Baron shares the primary trial results demonstrating non-inferiority of Wolverine therapy versus Shockwave.
Why MSA Is an Important Endpoint
Dr. Baron discusses why minimal stent area is a validated surrogate endpoint for long-term clinical outcomes.
Other Key Findings Beyond the Primary Endpoint
Dr. Baron discusses additional calcium modification findings including stent expansion and calcium fracture analysis.
Safety Outcomes from ShortCUT
Dr. Baron gives a review of the comparable safety outcomes observed between treatment strategies.
The Economic Impact of Device Choice
Dr. Baron gives an analysis of procedural costs and the economic differences between Shockwave and Wolverine therapy.
How ShortCUT May Change Practice
Dr. Baron shares how ShortCUT supports a toolbox approach to calcium modification and may influence future treatment decisions.
Want to continue your calcium education?
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CAUTION: The law restricts these devices to sale by or on the order of a physician.
SEISMIQ™ 4CE is an investigational device. Limited by US law to investigational use only. Not available for sale.