Complex coronary and peripheral lesions with heavy calcification present major challenges to stent delivery and optimal expansion. The Atherectomy Techniques session focuses on how rotational, orbital, laser, and intravascular lithotripsy-based approaches can modify plaque to enable safer, more effective revascularization. Participants will review lesion assessment, device selection, and technique optimization for calcified, fibrotic, and ostial segments. The session emphasizes practical decision-making in the cath lab, highlighting when atherectomy is essential, when it is optional, and when it may be best avoided.

Interventional teams increasingly seek an cardiology conference to deepen their understanding of device capabilities and limitations in real-world cases. This session walks through stepwise strategies for preparing lesions before balloon angioplasty and stenting, using intravascular imaging to characterize calcium distribution and thickness. Attendees will examine how vessel size, tortuosity, and plaque morphology guide the choice between rotational, orbital, or other plaque-modifying systems. Detailed case examples will illustrate how appropriate atherectomy can reduce stent underexpansion, malapposition, and subsequent restenosis.

A core emphasis is on the safe application of coronary atherectomy techniques. Participants will learn how to manage burr or crown speeds, stepwise debulking, and contrast use while minimizing complications such as slow flow, dissection, perforation, and distal embolization. Practical tips cover guide support, wire selection, hemodynamic monitoring, and the role of adjunctive pharmacology. The session also addresses atherectomy in high-risk patients, including those with left main disease, reduced ejection fraction, diffuse calcification, or chronic kidney disease, where careful planning and hemodynamic support may be required.

Beyond immediate procedural concerns, the session explores how systematic use of imaging and plaque-modifying strategies can improve long-term outcomes and reduce repeat interventions. Attendees will gain insight into training requirements, case selection for fellows, and documentation standards that support quality programs. By the end, participants will be better prepared to incorporate atherectomy into a comprehensive interventional toolkit, using it wisely and safely to tackle some of the most challenging lesions in practice.