This month we look at TAVR in patients with sarcopaenia; compare whether CCTA is more sensitive than TEE for device surveillance after LAAC; examine the influence of multidirectional shear stress on plaque progression and compositional changes in coronary arteries; introduce a new technology – intravascular lithotripsy (IVL) – for the treatment if calcific coronary and peripheral artery stenoses; and discuss the feasibility of an intravascular ultrasound-based energy delivery system for pulmonary artery denervation.