[Seniors and coronary calcified lesions]

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Updated: Sep 10, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.3K

Ikram El Marzouki1, Jacques Monsegu2

  • 1Institut Cardio Vasculaire, Groupe Hospitalier Mutualiste de Grenoble, 8 rue du Dr Calmette, 38000 Grenoble, France.

Annales De Cardiologie Et D'Angeiologie
|August 21, 2025
PubMed

Insights

Percutaneous coronary intervention (PCI) in elderly patients with severe coronary artery calcification can be challenging. This case demonstrates successful multi-step PCI using advanced plaque modification techniques, regardless of age.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Cardiology

Background:

  • Coronary artery calcification is common in elderly individuals, complicating percutaneous coronary intervention (PCI).
  • ST-elevation myocardial infarction (STEMI) in the elderly requires careful consideration of revascularization strategies.
  • Advanced plaque modification techniques may be necessary for complex calcified lesions.

Purpose of the Study:

  • To report a case of successful multi-step PCI in an 86-year-old patient with extensive coronary artery calcification and STEMI.
  • To highlight the importance of comprehensive geriatric assessment in guiding revascularization strategies.
  • To emphasize the utility of advanced plaque modification tools in elderly patients with complex coronary lesions.

Main Methods:

  • A case report of an 86-year-old male with STEMI and triple-vessel disease.
  • Multi-step PCI involving rotational atherectomy, scoring balloon dilation, intravascular lithotripsy, and orbital atherectomy.
  • Comprehensive geriatric assessment, including frailty and physiological age evaluation.

Main Results:

  • Complete revascularization was achieved through a staged PCI approach over 15 days.
  • Advanced plaque modification techniques were successfully employed to manage heavily calcified lesions.
  • The patient tolerated the procedures well, underscoring the feasibility of aggressive revascularization in selected elderly patients.

Conclusions:

  • Age should not be a barrier to utilizing advanced PCI techniques for complex coronary artery disease.
  • Comprehensive geriatric assessment is crucial for tailoring revascularization strategies in elderly patients.
  • Advanced plaque modification and intravascular imaging are valuable tools for successful PCI in calcified lesions.

Keywords:
Athérectomie orbitaleAthérectomie rotationnelleCalcified coronary lesionsElderly patientsImagerie intravasculaireIntervention coronarienne percutanéeIntravascular imagingIntravascular lithotripsyLithotripsie intracoronaireLésions coronaires calcifiéesOrbital atherectomyPercutaneous coronary interventionRotational atherectomySujets âgés

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