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Breaking the deadlock of calcified coronary artery lesions: A contemporary review
Author(s) -
Fan Lampson M,
Tong David,
Mintz Gary S.,
Mamas Mamas A.,
Javed Ahmed
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29221
Subject(s) - medicine , percutaneous coronary intervention , conventional pci , intravascular ultrasound , calcification , coronary artery disease , coronary artery calcium , calcinosis , cardiology , calcium , radiology , intensive care medicine , myocardial infarction
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.