Open Heart (Feb 2023)

Contemporary percutaneous management of coronary calcification: current status and future directions

  • Fernando Macaya,
  • Nieves Gonzalo,
  • Javier Escaned,
  • Jonathan Hill,
  • Julian Yeoh,
  • Breda Hennessey,
  • Nilesh Pareek,
  • Evan Shlofmitz

DOI
https://doi.org/10.1136/openhrt-2022-002182
Journal volume & issue
Vol. 10, no. 1

Abstract

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Severe coronary artery calcification is one of the greatest challenges in attaining success in percutaneous coronary intervention, limiting acute and long-term results. In many cases, plaque preparation is a critical prerequisite for delivery of devices across calcific stenoses and also to achieve adequate luminal dimensions. Recent advances in intracoronary imaging and adjunctive technologies now allow the operator to select the most appropriate strategy in each individual case. In this review, we will revisit the distinct advantages of a complete assessment of coronary artery calcification with imaging and application of appropriate and contemporary plaque modification technologies in achieving durable results in this complex lesion subset.