Dec 16, 2021 by Philips
Reading time: 1-2 minutes

Calcified Lesions

An increasing number of patients with calcified coronary artery lesions are being referred for PCI. A recent pooled analysis reported moderate to severe target lesion calcification in 32% of patients.1

Saphenous vein graft and thrombus lesions masthead

Clinical challenges

  • Angiographic measures of procedural success, such as acute gain and diameter stenosis, are often worse in calcified lesions.
  • Stent under-expansion, asymmetric expansion, and mal-apposition are frequently observed in heavily calcified lesions.
  • Noncompliant calcified plaques often require high-pressure balloon dilation, increasing the risk for adverse events such as coronary dissection and thrombosis.

Advanced tools for optimal PCI outcomes

IVUS software image

  • Detects coronary artery calcification. 
  • Helps quantify calcium burden, which may impact treatment strategy.

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1. Généreux P, Madhavan MV, Mintz GS, Maehara A, Palmerini T, Lasalle L, Xu K, McAndrew T, Kirtane A, Lansky AJ, Brener SJ, Mehran R, Stone GW. Ischemic outcomes after coronary intervention of calcified vessels in acute coronary syndromes. Pooled analysis from the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) and ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) TRIALS. J Am Coll Cardiol. 2014 May 13;63(18):1845- 54. doi: 10.1016/j.jacc.2014.01.034. Epub 2014 Feb 19. PMID: 24561145.

2. Ambrosini, V, Early outcomes of high energy laser (Excimer) facilitated coronary angioplasty on hard and complex calcified and balloon resistant coronary lesions: LEONARDO Study. Card. Revasc. Med 2015: 16: 141-146 and Luc Bilodeau, MD, et al. Novel Use of a High-Energy Excimer Laser Catheter for Calcified and Complex Coronary Artery Lesions. Catheterization and Cardiovascular Interventions (62:155-161, 2004).

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