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Contemporary Management of Severely Calcified Coronary Lesions

Natthapon Angsubhakorn1, Nicolas Kang2, Colleen Fearon1

  • 1Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.

Journal of Personalized Medicine
|October 27, 2022
PubMed

Insights

Coronary artery calcification poses challenges for percutaneous coronary intervention and increases cardiovascular event risk. This review details plaque modification techniques and emphasizes intravascular imaging for tailored treatment strategies.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Devices

Background:

  • Coronary artery calcification (CAC) is a growing clinical concern.
  • Severe CAC impedes percutaneous coronary intervention (PCI) success.
  • CAC is linked to increased short-term and long-term adverse cardiovascular events.

Purpose of the Study:

  • To review current modalities for modifying calcified coronary plaque.
  • To compare the advantages and disadvantages of different plaque modification techniques.
  • To highlight the role of intravascular imaging in guiding calcium modification therapy.

Main Methods:

  • Review of existing literature on coronary calcium modification techniques.
  • Discussion of balloon angioplasty, coronary atheroablation (rotational, orbital, laser), and intravascular lithotripsy.
  • Emphasis on the utility of intravascular imaging for lesion characterization.

Main Results:

  • Various techniques exist for modifying calcified coronary lesions.
  • Each modality offers distinct benefits and drawbacks.
  • Intravascular imaging is crucial for assessing calcification severity and morphology.

Conclusions:

  • Tailoring calcium modification therapy based on lesion characteristics is essential.
  • Intravascular imaging aids in selecting the optimal treatment strategy.
  • Effective management of CAC improves PCI outcomes and reduces cardiovascular event risk.

Keywords:
coronary artery calcificationintravascular imagingpercutaneous coronary intervention

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