Breaking the deadlock of calcified coronary artery lesions: a contemporary review.

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Authors
Fan, Lampson M
Issue Date
2021-01-01
Journal
Type
Article
Peer-Reviewed Publication
Keywords
Atherectomy
Calcified lesion
Contemporary review
Coronary angiography
Coronary artery disease
Coronary atherectomy
Coronary calcification
Intracoronary imaging
Peer-reviewed article
Percutaneous coronary intervention
Review
Severity of illness index
Treatment outcome
Vascular calcification
Journal Title
Catheterization and Cardiovascular Interventions
Volume
97
Issue
1
Begin page
108
End page
120
Abstract
Percutaneous coronary intervention (PCI) of severely calcified lesions is known to result in lower procedural success rates, higher complication rates, and worse long-term clinical outcomes compared to noncalcified lesions. Adequate lesion preparation through calcium modification is crucial in ensuring procedural success and reducing adverse cardiovascular outcomes. There are numerous calcium modification devices currently available whose usefulness depends on the nature of the calcific disease and its anatomical distribution. It can be challenging for the interventionists to decide which device is best suited for their patient. There is also emerging evidence for intravascular imaging in guiding selection of calcium modification devices using parameters such as calcium distribution and depth that directly impact on procedural success and clinical outcomes. In this review we aim to discuss the pathophysiology of coronary calcification, evaluate strategies and technologies of calcium modification and propose an A-M-A-S-A algorithm in managing calcified coronary lesions.
Citation
Fan LM, Tong D, Mintz GS, Mamas MA, Javed A. Breaking the deadlock of calcified coronary artery lesions: A contemporary review. Catheter Cardiovasc Interv. 2020 Aug 31. doi: 10.1002/ccd.29221. Epub ahead of print. PMID: 32865328.
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