A case of chronic total occlusion of the left circumflex artery with extensive and deep calcification was confirmed by coronary angiography and intravascular ultrasound.None of the Lacrosse non-slip elements(NSE)were adequately dilated after the guide-wire passed through the occluded segment.However,multiple tan-dem localization of segmented lesions using Pull-Back shockwave balloon effectively optimized the pre-treatment of long and deep calcification lesions,ensuring that the surgery was completed successfully and without any complications.
intravascular lithotripsylong calcificationdeep calcificationshockwave balloonchronic total occlusion