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Real Cases and Insights: Expert Reviews

Welcome to School of Rock, an on-demand video hub bringing together leading coronary calcium experts to share best practices, clinical challenges, case studies, and explore contemporary coronary calcium modification tools and techniques.

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.

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. 

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.

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