Podcast #54 · 29 Sept 2026
Understanding the Use of Ultra-High Pressure Balloons in PCI
- Percutaneous Coronary Intervention (PCI)
- In-Stent Restenosis (ISR)
- Cardiology
- Interventional Cardiology (IC)
- Coronary Artery Calcification
- Coronary Perforation
- Intravascular Ultrasound (IVUS)
When a coronary lesion won’t open at conventional pressures, what can an ultra-high pressure balloon do differently? On this episode of BackTable Cardiology, host Dr. Hady Lichaa welcomes Dr. Deepak Kapoor, interventional cardiologist at the Medical College of Georgia at Augusta University, to discuss the science, safety, and real-world applications of ultra-high pressure (UHP) balloons in calcified coronary intervention. Dr. Kapoor walks through the evolution of balloon design, the main scenarios where UHP balloons are most useful, and the technical details that set these devices apart from standard non-compliant balloons and other calcium modification tools.
This podcast is supported by
Timestamps
Resources
- Very high-pressure dilatation for undilatable coronary lesions: indications and results with a new dedicated balloon (EuroIntervention, 2016)
- Super high-pressure balloon versus scoring balloon to prepare severely calcified coronary lesions: the ISAR-CALC randomised trial (EuroIntervention, 2021)
- Safety and efficacy of super-high pressure OPN balloon in patients with in-stent restenosis, an intracoronary imaging-based observational study (Scientific Reports, 2025)
- VICTORY: intravascular lithotripsy versus super-high-pressure balloons in calcified and refractory coronary lesions (PCR, TCT 2025)
More about this episode
The conversation covers IVUS-led planning, device selection for different calcium morphologies, inflation strategies, and practical tips to avoid complications like rupture or dissection. Dr. Kapoor shares his approach to in-stent restenosis, cost considerations, and what the future may hold for calcium modification. The conversation closes with advice for operators new to UHP balloons, the importance of post-procedure imaging, and how to stay safe when pushing past traditional pressure limits.