PCI of calcified coronary stenoses

Calcified coronary stenoses increasingly challenge the interventional cardiologist. Treatment is demanding, complications more frequent. Traditional and more recent strategies and devices are available to prepare such lesions for stenting. What are their advantages and shortcomings, and how can they best be applied? Intracoronary imaging offers intraprocedural quality-control. This is an attempt to propose an algorithm to optimize and combine the use of this armamentarium.