1. Contemporary Evidence-Based Diagnosis and Management of Severe Coronary Artery Calcification.
- Author
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Doost, Ata, Rankin, James, Sapontis, James, Ko, Brian, Lo, Sidney, Jaltotage, Biyanka, Dwivedi, Girish, Wood, David, Byrne, Jonathan, Sathananthan, Janarthanan, and Ihdayhid, Abdul Rahman
- Subjects
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CORONARY artery calcification , *ENDARTERECTOMY , *ATHERECTOMY , *EVIDENCE-based management , *MUCOCUTANEOUS lymph node syndrome , *MYOCARDIAL infarction , *MEDICAL care , *CARDIOVASCULAR system , *TREATMENT effectiveness , *CORONARY angiography , *CALCINOSIS , *CORONARY artery disease , *CALCIUM - Abstract
Percutaneous treatment of heavily calcified coronary lesions remains a challenge for interventional cardiologists with increased risk of incomplete lesion preparation, suboptimal stent deployment, procedural complications, and a higher rate of acute and late stent failure. Adequate lesion preparation through calcium modification is crucial in optimising procedural outcomes. Several calcium modification devices and techniques exist, with rotational atherectomy the predominant treatment for severely calcified lesions. Novel technologies such as intravascular lithotripsy are now available and show promise as a less technical and highly effective approach for calcium modification. Emerging evidence also emphasises the value of detailed characterisation of calcification severity and distribution especially with intracoronary imaging for appropriate device selection and individualised treatment strategy. This review aims to provide an overview of the non-invasive and invasive evaluation of coronary calcification, discuss calcium modification techniques and propose an algorithm for the management of calcified coronary lesions. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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