Percutaneous Revascularization of Thrombotic and Calcified Coronary Lesions

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(3), С. 692 - 692

Опубликована: Янв. 22, 2025

Percutaneous coronary intervention (PCI) for thrombotic and heavily calcified artery lesions occlusions is often hampered by difficulty in wiring the occlusions, restoring antegrade flow, proceeding to successful stent implantation. Characterization of dynamic anatomical features such as thrombi calcium distribution key prevent periprocedural complications long-term adverse events, which are mainly driven underexpansion malapposition may prompt in-stent restenosis or thrombosis. Therefore, multimodal imaging a critical step during PCI better characterize these high-risk select those careful preparation with debulking devices needed guide optimization aim improving procedural clinical outcomes. Hence, obtaining understanding underlying cause thrombus formation, distribution, thorough planning remain crucial steps selecting optimal revascularization strategy an individual patient. In this review, we summarize current evidence about prevalence, predictors, outcomes “hard-rock” treated PCI, focusing on value physiological assessments performed interventions. Furthermore, provide overview cutting-edge technologies facilitating use according specific features.

Язык: Английский

---

Orbital atherectomy versus balloon angioplasty before drug-eluting stent implantation in severely calcified lesions eligible for both treatment strategies (ECLIPSE): a multicentre, open-label, randomised trial

The Lancet, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Язык: Английский

---

‘RotaShock’ – A Revolution in Calcium Modification: Long‑term Follow-up from a Single High-volume Centre

Interventional Cardiology Reviews Research Resources, Год журнала: 2025, Номер 20

Опубликована: Март 10, 2025

Background: Rotational atherectomy (RA) and intravascular lithotripsy (IVL) are well-established technologies for modification of coronary calcification. Given their contrasting mechanisms action, there has been interest in whether the use these devices conjunction could potentially be synergistic offer improved procedural results. The aim this study was therefore to evaluate efficacy, safety long-term outcomes combining RA IVL, termed ‘RotaShock’ (RSK), treatment severe Methods: A single-centre retrospective analysis carried out consecutive patients treated with an RSK strategy calcification from January 2019 until September 2022. Baseline demographics, comorbidity details, details percutaneous intervention procedure, angiographic and/or intracoronary imaging (ICI) results presence target vessel revascularisation or mortality were recorded. Results: total 36 RSK; majority male (n=29; 80.6%) median age 75 years (IQR 70–79 years). cases involved treating left anterior descending artery (63.4%) but one-third main artery. vast guided by ICI (88.9%) performed through radial access (80.6%). In available analysis, minimum stent area 7.7 mm2 6.2–10.0 mm2). There two site complications no other periprocedural complications. follow-up 942 days 645–1,306 days). Despite high complexity lesions treated, identified only revascularisation. five non-adjudicated all-cause mortality. Conclusion: is effective safe calcification, suggesting a highly durable result. Further randomised data now mandated relative merits compared IVL alone.

Язык: Английский

---

Orbital atherectomy for severely calcified coronary artery lesions

The Lancet, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

Язык: Английский

---

Clinical Implications of Calcification Severity Adjacent to Calcified Nodule: Its Association with First and Recurrent Risks of Target Lesion Revascularization after Percutaneous Coronary Intervention

Atherosclerosis, Год журнала: 2025, Номер 402, С. 119116 - 119116

Опубликована: Янв. 28, 2025

Язык: Английский

---

Management of Coronary Stent Underexpansion

Journal of the American College of Cardiology, Год журнала: 2025, Номер 85(6), С. 625 - 644

Опубликована: Фев. 1, 2025

Язык: Английский

---

Calcified Coronary Artery Disease: Pathology, Prevalence, Predictors and Impact on Outcomes

Interventional Cardiology Reviews Research Resources, Год журнала: 2025, Номер 20

Опубликована: Фев. 14, 2025

Calcified coronary artery disease is a common clinical finding and visible angiographically in 25–30% of patients presenting for percutaneous intervention. The presence calcium, even without obstruction, confers an adverse prognosis. Coronary calcium score on CT additive predicting risk cardiovascular events beyond traditional scoring systems. Deposition arteries initiated by the formation atherosclerotic plaque. Thereafter, multiple processes pathways are involved, resulting initial microcalcifications that coalesce into sheets. nodules thought to occur from rupture these stenoses requiring revascularisation result greater target lesion failure overall major than non-calcified lesions, regardless mode revascularisation. Modifying prior stenting optimise stent expansion required intracoronary imaging can greatly facilitate not only detection but also confirmation adequate modification optimisation. In this review, authors examine pathophysiology, prevalence, predictors impact outcomes calcium.

Язык: Английский

---

Perspectives in the Diagnosis, Clinical Impact, and Management of the Vulnerable Plaque

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(5), С. 1539 - 1539

Опубликована: Фев. 25, 2025

Coronary artery disease is a highly prevalent that constitutes the leading cause of mortality worldwide. Acute coronary syndromes are most devastating form presentation disease, involving acute formation thrombus within vessel lumen, further to flow limitation and diminished myocardial perfusion. Vulnerable plaques, which characterized by thin-cap fibroatheroma, large lipid pool, macrophage infiltration spotty calcification cap, pose higher risk events despite not being flow-limiting. Iterations in intravascular imaging computed tomography have largely increased ability detect define vulnerable its clinical impact early- mid-term outcomes has been confirmed several studies. In this review, we aimed revise current concept plaque repercussion, summarize main pharmacological approaches for management, provide an updated overview available evidence on preventive percutaneous interventional strategies setting.

Язык: Английский

---

Approach to Coronary Calcium and Procedural Techniques During Percutaneous Coronary Intervention

Current Treatment Options in Cardiovascular Medicine, Год журнала: 2025, Номер 27(1)

Опубликована: Март 11, 2025

Язык: Английский

---

The Significance of Coronary Artery Calcification for Percutaneous Coronary Interventions

Healthcare, Год журнала: 2024, Номер 12(5), С. 520 - 520

Опубликована: Фев. 22, 2024

The prevalence of calcium deposits in coronary arteries grows with age. Risk factors include, e.g., diabetes and chronic kidney disease. There are several underlying pathophysiological mechanisms deposition. Severe calcification increases the complexity percutaneous interventions. Invasive techniques to modify calcified atherosclerotic plaque before stenting have been developed over last years. They include balloon- non-balloon-based techniques. Rotational atherectomy has most common technique treat lesions but new emerging (orbital atherectomy, intravascular lithotripsy, laser atherectomy). use imaging (intravascular ultrasound optical coherence tomography) is especially important during procedures order choose optimal strategy assess final effect procedure. This review provides an overview role for

Язык: Английский

---