The New Era of Coronary Angioplasty: How Cutting-Edge Technologies are Redefining Complex Interventions

Interventional cardiologists have recently become increasingly entrusted with the treatment of frail patients with complex coronary anatomy. Additionally, calcified lesions (CLs) have become more common due to the continued increase in the older population worldwide, increasing the need for simpler treatment options for such complex lesions. Hence, numerous debulking tools have recently been developed to overcome the difficulties associated with the angioplasty of CLs and to optimize stent positioning and delivery. In addition, bifurcation lesions (BLs) have always been more challenging than other lesions, requiring more specialized tools and complex strategies. Finally, intravascular imaging (IVI) is becoming increasingly important in assessing the complexity of lesions and optimizing procedural approaches. This article provides an overview of how complex procedures should be approached, from the choice of access and catheter to the use of specialized devices developed to assist cardiac catheterization laboratory operators in these complex scenarios.