Use of Calcium Modification in Percutaneous Coronary Intervention: A Comprehensive Review

Ramazani Noyan; Ala Abdallah; Michael V Dicaro; Sharma Divyansh; Aditi Singh; Lei KaChon

doi:10.3390/jcm14228130

Back

Use of Calcium Modification in Percutaneous Coronary Intervention: A Comprehensive Review

Journal article

Open access

Peer reviewed

Use of Calcium Modification in Percutaneous Coronary Intervention: A Comprehensive Review

Ramazani Noyan, Ala Abdallah, Michael V Dicaro, Sharma Divyansh, Aditi Singh and Lei KaChon

Journal of clinical medicine, Vol.14(22), 8130

01/01/2025

DOI: 10.3390/jcm14228130

PMCID: PMC12653255

PMID: 41303167

Files and links (1)

url

https://doi.org/10.3390/jcm14228130View

Published (Version of record) Open Access

Abstract

Calcified coronary lesions remain a challenge in percutaneous coronary intervention (PCI) in both situations of acute myocardial infarction (MI) and stable coronary syndrome. It significantly increases the risk of procedural complications due to difficulty in equipment delivery, balloon expansion, and stent delivery. Furthermore, stent thrombosis, dissection, perforation, and future in-stent restenosis occur more frequently in calcified coronary lesions, impacting repeat target vessel revascularization and increasing the risk of future MI. With intracoronary imaging (intravascular ultrasound and optical coherence tomography), peri-procedural success for treating calcified lesions has increased significantly. Different modalities of calcium modification techniques have since been introduced. This review will discuss the pathophysiology and phenotypes of calcium deposition in the coronary vessels, including eccentric calcified plaques and calcified nodules. We will also focus on calcium modification techniques and their mechanisms: (1) Balloon escalation technique, (2) intravascular lithotripsy, (3) orbital atherectomy, and (4) rotational atherectomy. We will focus on the strengths and limitations of each technique, based on current recommendations and expert consensus from SCAI. We will also provide contemporary evidence of each modality for treating different phenotypes of calcified lesions. In summary, this article provides a comprehensive review of current guidelines for optimizing the treatment of calcified coronary lesions in PCI.

Angioplasty

Apoptosis

Cardiovascular Disease

Cytokines

Diabetes

Hypertension

Inflammation

Kidney Diseases

Metabolism

Oxidative Stress

Vein & Artery Diseases

Acute coronary syndromes

Angina pectoris

Atherosclerosis

Calcification

Cardiomyocytes

Coronary vessels

Kinases

Lipids

Proteins

Risk factors

Transcription factors

Tumor necrosis factor-TNF

Details

Title: Subtitle: Use of Calcium Modification in Percutaneous Coronary Intervention: A Comprehensive Review
Creators: Ramazani Noyan - University of Nevada, Las Vegas
Ala Abdallah - University of Iowa
Michael V Dicaro - University of Nevada, Las Vegas
Sharma Divyansh - University of Nevada, Las Vegas
Aditi Singh - University of Nevada, Las Vegas
Lei KaChon - University of Nevada, Las Vegas
Resource Type: Journal article
Publication Details: Journal of clinical medicine, Vol.14(22), 8130
DOI: 10.3390/jcm14228130
PMID: 41303167
PMCID: PMC12653255
NLM abbreviation: J Clin Med
ISSN: 2077-0383
eISSN: 2077-0383
Publisher: MDPI AG; Basel
Grant note: Kirk Kerkorian School of Medicine, UNLV, Department of Internal MedicineKirk Kerkorian School of Medicine, UNLV, Library Open Article Fund
The majority of publication fees for this article were graciously supported by the Kirk Kerkorian School of Medicine, UNLV, Library Open Article Fund. The remaining publication fees were generously supported by the Kirk Kerkorian School of Medicine, UNLV, Department of Internal Medicine.
Language: English
Date published: 01/01/2025
Academic Unit: Internal Medicine
Record Identifier: 9985034138902771

Metrics

4 Record Views