Many breeds are better than a workhorse

INTRODUCTION In your job, in your social relationships, in your life in general, experience means learning how much pressure you are allowed to put on yourself and the environment around you to achieve your goal. The same rule applies in interventional cardiology when a stubborn fibrotic or calcific lesion does not wish to bend to your desire to crack it open. Doing it intelligently means applying sufficient pressure with a balloon of appropriate diameter, length, and compliance. The Authors of this article apply the term dog-boning somewhat inappropriately. Dog-boning should be reserved to instances with growth out of proportion of the balloon extremities whereas the center of the balloon remains grossly underdilated. In Fig. 1B they show an example of what they call ‘‘severe dog-boning’’ but the balloon extremities are only slightly bigger than the 6 Fr guiding catheter and QCA measures a maximum balloon diameter of 2.65 mm, quite all right for a low compliant 2.5 mm balloon at 30 atm.