Parallax by Ankur Kalra

In this insightful episode of Parallax, Dr Ankur Kalra welcomes Dr Robert Riley, Director of Interventional Cardiology at Overlake Medical Center in Bellevue, Washington, for a masterclass on the contemporary management of complex PCI. Drawing on more than a decade of experience, Dr Riley explores how the field has evolved beyond technical success alone, with greater emphasis on patient selection, shared decision-making and aligning procedural goals with individual patient outcomes. The conversation takes a deep dive into the assessment and treatment of calcified coronary lesions, with a particular focus on the challenge of nodular calcium. Dr Riley shares his practical approach to intravascular imaging, lesion preparation and plaque modification, discussing when to utilise atherectomy, intravascular lithotripsy (IVL) and OPN balloons. He also highlights his growing use of drug-coated balloons in de novo lesions and provides insights into tailoring DAPT duration based on individual patient risk. For interven