# Case Report: Overcoming calcified nodules by repeated aggressive debulking and stent-free percunatenous coronary intervention using a drug-coated balloon

## TL;DR

A 76-year-old man with recurring heart artery blockage due to calcified nodules was successfully treated with a new method involving repeated tissue removal and drug-coated balloon angioplasty.

## Contribution

This case report demonstrates the effectiveness of repeated stent-free PCI with debulking and drug-coated balloons for calcified nodules.

## Key findings

- The patient remained free of restenosis for four years after three sessions of stent-free PCI and drug-coated balloon treatment.
- Aggressive debulking of calcified tissue combined with drug-coated balloon angioplasty showed promising results in managing calcified nodules.
- This approach offers a potential alternative to traditional stent-based interventions for calcified coronary lesions.

## Abstract

The outcomes of percutaneous coronary intervention (PCI) for calcified nodules (CNs) has been unsatisfactory results, even with the use of drug eluting stents. The optimal treatment strategy for CNs continues to be a matter of debate, with no definitive solution in sight.

We present a case of a 76-year-old male with recurrent restenosis due to a CNs in the ostium of left circumflex artery. He underwent repeated stent-free PCI with aggressive debulking using atherectomy devices followed by drug coated balloon (DCB).

The patient experienced recurrent restenosis every six months; however, after undergoing three sessions of stent-free PCI using atherectomy device and DCB, the lesion remained free of restenosis witch was confirmed at 4 years follow up.

This case highlights the potential of repeated stent-free PCI with debulking of calcified tissue followed by DCB angioplasty as a viable treatment option for CNs.