Complex Coronary Interventions

Not every narrowing needs a stent. The decision to intervene is based on whether the blockage is truly limiting blood flow to the heart, using both imaging and pressure-based measurements inside the artery.

• The coronary arteries deliver oxygen-rich blood to the heart muscle
• Over time, cholesterol and calcium can build up inside these arteries, restricting blood flow
• When a blockage becomes severe enough to cause chest pain, shortness of breath, or risk of heart attack, an intervention may be needed
• Percutaneous coronary intervention (PCI) uses small catheters threaded through a wrist or leg artery to open the blocked vessel from the inside — without open-heart surgery

Înainte de a interveni, fiecare leziune este evaluată cu precizie: cât de strâmtă este artera și, mai important, dacă acea îngustare chiar reduce fluxul de sânge către inimă. Doar leziunile cu adevărat semnificative sunt tratate.

• A thin catheter is guided through the blood vessels to the site of the blockage
• Intravascular imaging (IVUS / OCT) provides a detailed view inside the artery to assess plaque composition and vessel size
• Functional testing (FFR / iFR) measures whether the narrowing is actually reducing blood flow to the heart
• Based on these findings, the blockage is treated with balloon dilation, stent placement, or specialized plaque-modification tools
• The result is checked with repeat imaging to confirm optimal blood flow restoration

• Patients with chest pain (angina) or shortness of breath caused by coronary blockages
• Acute heart attack requiring emergency vessel opening
• Severely calcified arteries that standard balloons cannot expand
• Blockages at artery branch points (bifurcation lesions) requiring tailored strategies
• Completely blocked arteries (chronic total occlusions, or CTO) in selected patients
• Multiple blocked arteries (multivessel disease) requiring a comprehensive revascularization plan
• Patients with prior stents that have re-narrowed (in-stent restenosis) or clotted (stent thrombosis)

• IVUS / OCT-guided PCI (ultrasound and light-based imaging inside the artery)
• Functional lesion assessment with FFR / iFR (pressure wire testing to measure flow significance)
• Intravascular lithotripsy — IVL (shockwave therapy to crack heavy calcium deposits)
• Rotational and orbital atherectomy (high-speed devices that shave or sand away hard plaque)
• Bifurcation techniques — provisional stenting and two-stent strategies for branch-point disease
• Chronic total occlusion (CTO) recanalization using antegrade and retrograde wire techniques
• Drug-coated balloons — DCB (delivering medication directly to the vessel wall without leaving a permanent implant)
• Imaging-guided stent optimization to ensure proper expansion and wall contact