Abstract
Nodular calcium in the coronary artery poses a great challenge during coronary intervention. Although rotational atherectomy is the preferred modality of treatment of nodular calcium, we treated the left main coronary artery (LMCA) nodular calcium with a scoring balloon during primary angioplasty of an octogenarian with anterior wall myocardial infarction and EKG suggestive of LMCA occlusion. During primary coronary angioplasty, the scoring balloon alone also sometimes suffices in achieving good angiographic results and thrombolysis in myocardial infarction grade III (TIMI III) flow.