{
  "abstract": "Background\n\nGrayscale intravascular ultrasound grades coronary calcium but cannot detect lipid sequestered behind a calcific plate because both attenuate the ultrasound signal.Case summary\n\nA 56-year-old man with palpitations and exertional chest discomfort had double-vessel disease: a critical proximal left anterior descending (LAD) stenosis and a severe mid-to-distal right coronary artery (RCA) lesion. Coregistered near-infrared spectroscopy and intravascular ultrasound showed near-circumferential calcium in both vessels, with a large lipid core hidden beneath the LAD calcific shell (maximum lipid core burden index over 4 mm: 788) and a lipid-poor RCA focus (maximum lipid core burden index over 4 mm: 249). Lithotripsy and drug-eluting stents were used in both vessels. The lipid-rich LAD expanded well; the lipid-poor RCA focus did not.Take-home message\n\nPlaque chemistry, not calcium geometry alone, may explain why some calcified segments resist lithotripsy.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Allied and Healthcare Sciences, Jamia Hamdard, New Delhi, India.",
    "Innovative Therapeutic Pvt. Ltd., Chennai, Tamil Nadu, India.",
    "Department of Allied and Healthcare Sciences, Jamia Hamdard, New Delhi, India. Electronic address: sraza@jamiahamdard.ac.in."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Syed Nazar Raza"
    },
    {
      "affs": [
        1
      ],
      "name": "Md Rehan Akhtar"
    },
    {
      "affs": [
        0
      ],
      "name": "Manav Jyala"
    },
    {
      "affs": [
        2
      ],
      "name": "Syed Abeera Andrabi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4949v3gzxp4kh.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jaccas.2026.110264",
  "fulltext_url": "https://europepmc.org/articles/PMC13669885",
  "id": "4949v3gzxp4kh",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://europepmc.org/article/MED/42847579",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Coronary Interventions and Diagnostics"
    ]
  ],
  "openalex": "W7220866276",
  "pdf_url": "https://europepmc.org/articles/PMC13669885?pdf=render",
  "pmcid": "PMC13669885",
  "pmid": "42847579",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4949v3gzxp4kh.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:10Z",
      "native_id": "MED:42847579",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42847579"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Coronary Interventions and Diagnostics",
      "subfield": "surgery"
    }
  ],
  "title": "Lipid-Rich Plaque Beneath Dense Calcium: Imaging-Guided Lithotripsy in Calcified Double-Vessel Disease.",
  "title_text": "Lipid-Rich Plaque Beneath Dense Calcium: Imaging-Guided Lithotripsy in Calcified Double-Vessel Disease.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:10Z",
  "url": "https://research.draconitic.com/paper/4949v3gzxp4kh",
  "venue": "JACC. Case reports",
  "versions": []
}