‘Pre-crack the plaque technique’ using OPN super high-pressure balloons in tight, calcified stenoses: A case series

The OPN super high-pressure balloon is a safe and effective up-front plaque modification tool that facilitates lesion expansion and optimal stent deployment in tight, calcified coronary stenoses. Here we describe a case series of OPN use with very small diameter balloons (1.5–2.5 mm) in tight stenoses and subsequent larger non-compliant (NC) balloon inflation that expands existing calcium fractures. It is best guided by intracoronary imaging, but may have acceptable safety profile even when imaging catheters will not initially cross. This technique may be efficient and cost-effective in applicable cases, relative to other modification options. It is. This technique appears to be a safe, effective, and technically straightforward method for modifying some tight, reasonably calcified coronary lesions. ‘Pre-Crack the Plaque Technique’ using OPN Super High-Pressure Balloons in Tight, Calcified Stenoses: a Case Series. The OPN super-high-pressure-balloon is a safe and effective up-front plaque modification tool that facilitates lesion expansion and optimal stent deployment in tight, calcified coronary stenoses. Here we show OPN use with small diameter balloons (1.5–2.5 mm) in tight stenoses and subsequent larger non-compliant (NC) balloon inflations that expand existing calcium fractures. • Small OPN balloons safely modified tight, calcified coronary stenoses • High-pressure inflations (35–40 atm) initiated early calcium fractures • Technique enabled effective NC balloon expansion and stent deployment • Approach feasible even when imaging catheters could not initially cross • Simple, cost-effective option for select calcified coronary interventions