Related Experiment Video
Updated: Jun 8, 2026
In situ Compressive Loading and Correlative Noninvasive Imaging of the Bone-periodontal Ligament-tooth Fibrous Joint
Published on: March 7, 2014
Stent-Edge Hinge Movement in a Calcified Lesion Is Associated With Increased Prevalence of a Calcified Nodule at
Yoichiro Sugizaki1,2,3, Mitsuaki Matsumura1, Yu-Wei Chen1,3
1Clinical Trials Center, Cardiovascular Research Foundation, New York, NY (Y.S., M.M., Y.-W.C., T.T., T.K., J.W.M., O.K.K., D.J.C., G.S.M., A.J., Z.A.A., A.M.).
Insights
Calcified nodules are more common at stent edges than in native vessels, increasing the risk of major adverse cardiac events after stenting. This highlights the importance of considering calcium burden in stent placement.
Area of Science:
- Cardiovascular research
- Interventional cardiology
- Medical imaging
Background:
- Coronary stenting can alter local vessel dynamics.
- The precise relationship between stent-edge calcium and calcified nodule (CN) formation requires further investigation.
Purpose of the Study:
- To investigate the frequency of calcified nodules (CNs) at stent edges compared to native calcified lesions.
- To identify factors associated with CN development at stent edges.
- To assess the clinical impact of stent-edge CNs on major adverse cardiac events (MACE).
Main Methods:
- Optical coherence tomography (OCT) was used to evaluate 989 stent-edge calcified lesions and 354 unstented native calcified lesions in 801 patients.
- Lesions were categorized based on the presence or absence of CNs and whether they were at a stent edge or in a native vessel.
- Statistical analysis, including odds ratios (ORs), was performed to determine predictors of CN presence and MACE.
Main Results:
- Calcified nodules (CNs) were significantly more prevalent in stent-edge calcified lesions (15.7%) compared to native calcified lesions (5.1%) (P<0.001).
- Stent-edge location, greater calcium burden (length, arc, thickness), and larger systolic-diastolic angle changes predicted CN presence.
- Stent-edge CNs were associated with a higher rate of MACE (15.9% vs. 6.5%, P=0.01), primarily driven by target lesion revascularization.
Conclusions:
- Stent-edge calcium appears to predispose to the development of calcified nodules.
- The presence of stent-edge CNs is linked to an increased risk of major adverse cardiac events, regardless of lesion treatment status.
Background:
Coronary stenting alters vessel dynamics, displacing hinge movement closer to stent edges. We aimed to investigate whether calcified nodules (CNs) are more frequent at stent edges associated with calcium.
Methods:
In vessels with previously implanted stents evaluated by optical coherence tomography, 4 different calcified lesions were studied: stent-edge calcified lesions with or without a CN, and unstented native calcified lesions with or without a CN.
Results:
In 801 patients, 989 stent-edge calcified lesions and 354 unstented native calcified lesions were identified. Stent-edge calcified lesions exhibited a higher prevalence of CNs versus native calcified lesions (15.7% versus 5.1%; P<0.001) and were observed in locations (mid left anterior descending artery, mid left circumflex, or branches) where no unstented native vessel CNs were seen. Stent-edge (versus native vessel) location (odds ratio [OR], 4.58 [95% CI, 2.23-9.43]) predicted the presence of a CN. Correspondingly, greater angiographic (systole-diastole) ∆angle at the stent edge or unstented lesion (per 10°, OR, 2.27 [95% CI, 1.43-3.60]) and greater calcium burden: calcium length (per 10 mm, OR, 4.04 [95% CI, 2.36-6.92]), maximum calcium arc (per 90°, OR, 1.65 [95% CI, 1.25-2.17]), and maximum calcium thickness (per 0.1 mm, OR, 1.25 [95% CI, 1.15-1.36]) were associated with the presence of a CN. Stent-edge CNs were associated with a higher rate of stent-edge calcified lesion-related major adverse cardiac events (a composite of cardiac death, target vessel-related myocardial infarction, clinically driven target lesion revascularization, or definite/probable stent thrombosis) compared with stent edges without a CN (15.9% versus 6.5%; P=0.01), mainly driven by target lesion revascularization.
Conclusions:
Stent-edge calcium may predispose to the development of a CN. Stent-edge CNs were associated with a higher major adverse cardiac events rate than stent edges without a CN, whether treated or untreated.
Related Concept Videos
03:14Notch Signaling Pathway
The Notch gene came into the limelight in 1914 after the discovery that its mutation in Drosophila melanogaster leads to a serrated (or "notched") wing margin phenotype. It was not until 1985...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT