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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Risk Profile and Prognostic Implications of Percutaneous Coronary Intervention Procedure Failure in Patients With

Zhangyu Lin1,2,3, Zhihao Zheng1,2,3, Min Yang1,2

  • 1Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|December 29, 2025
PubMed

Insights

Percutaneous coronary intervention (PCI) failure in patients with moderate-to-severe coronary artery calcification (MSCAC) leads to worse cardiovascular outcomes. Intravascular ultrasound and rotational atherectomy can reduce PCI failure risk in these patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Interventional Cardiology

Background:

  • Arterial calcification is a key indicator of vascular aging.
  • Risk factors and outcomes of PCI failure in moderate-to-severe coronary artery calcification (MSCAC) patients require further investigation.

Purpose of the Study:

  • To analyze characteristics, risk factors, and long-term clinical outcomes of MSCAC patients experiencing PCI procedure failure.

Main Methods:

  • A cohort of 26,253 patients undergoing PCI was analyzed.
  • Procedure failure was defined by residual stenosis ≥50%, severe complications, or in-hospital death/myocardial infarction (MI).
  • Primary endpoint was major adverse cardiovascular events (MACE) over a median 3-year follow-up.

Main Results:

  • PCI procedure failure occurred in 10.96% of MSCAC patients.
  • MSCAC patients with PCI failure had a 2.38-fold increased risk of MACE compared to non-MSCAC patients.
  • Intravascular ultrasound (IVUS) and rotational atherectomy were protective against MSCAC-PCI failure.

Conclusions:

  • MSCAC patients with PCI failure face poorer long-term clinical outcomes.
  • IVUS and rotational atherectomy are associated with reduced risk of PCI procedure failure in severe calcification.
Abstract

Keywords:
moderate‐to‐severe calcificationpercutaneous coronary interventionprocedure failure

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