LAUSR

Treatment of calcified lesions is associated with a greater risk of immediate complications and late failure, justifying the more frequent referral of these patients to coronary artery bypass graft surgery. Coronary calcifications have become more frequent because in contemporary percutaneous coronary interventions practice a growing number patients are elderly and have renal failure or diabetes, conditions associated with presence of coronary calcium that also make these patients not ideal surgical candidates. Rotational atherectomy (RA) was introduced more than 30 years ago and certainly allowed successful treatment of many otherwise uncrossable or undilatable lesions but failed to reach widespread adoption outside specialized centers. Orbital atherectomy (OA) offers potential advantages but shares some of the limitations of RA and is still waiting outcome data from an upcoming randomized trial. Intravascular lithotripsy (IVL) is a balloon‐based technique with the potential to transform our approach to calcified lesions and be applicable in very angulated lesions, large bifurcations, thrombus containing lesions