Nicola Ryan and Flavio Ribichini discuss the challenges of treating the calcified left main stem. They break down the complexities of this high-risk condition and highlight the role of mechanical circulatory support in everyday practice. They focus on the role of intracoronary imaging as a game-changer and examine the use of one versus two stents, outlining cases where two stents may be necessary.

Key takeaways

1. Calcified left main stem disease is complex but can be simplified with the right tools.

2. Intravascular imaging is crucial for accurate assessment and treatment planning.

3. A careful, step-by-step approach leads to the best angiographic results.

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