Figure 2 Stepwise explanation of the study procedures and decision-making process. The procedural guidelines for the study are delineated in a stepwise manner, encompassing several critical criteria. Morphological assessment involved identifying high calcium plaque characterized by an arc exceeding 180 degrees, thickness over 0.5 mm, and length of more than 5 mm. Landing zones for interventions were selected based on the visualization of healthy tissue and the external elastic lamina. Diameter criteria required measuring the dimensions of the vessel, stent, and balloon, with reference measurements taken distally to select stent and distal balloon sizes, and proximally for proximal balloons. Significant medial dissections, defined as those penetrating the medial layer and extending beyond 1 quadrant arc, were promptly addressed. Apposition criteria involved rectifying gross malposition, noted when the separation from the vessel wall exceeded 3 mm. Finally, expansion criteria verified stent deployment, with over 80% expansion considered acceptable and beyond 90% regarded as optimal, ensuring precision and efficacy in the intervention process.