Contemporary technologies to modify calcified plaque in coronary artery disease

Zach Rozenbaum, Tatsunori Takahashi, Yuhei Kobayashi, Dimitrios Bliagos, Mark Menegus, Antonio Colombo, Azeem Latib

Research output: Contribution to journalReview articlepeer-review

Abstract

With aging society, one of the more challenging obstacles in percutaneous coronary interventions are calcified coronary lesions. Calcified lesions may impede stent delivery, limit balloon and stent expansion, cause uneven drug distribution, and hinder wire advancement. Even in the setting of acceptable procedural success, vessel calcification is independently associated with increased target lesion revascularization rates at follow-up and lower survival rates. In order to effectively manage such lesions, dedicated technologies have been developed. Atherectomy aims at excising tissue and debulking plaques, as well as compressing and reshaping the atheroma, generally referred to as lesion preparation that enables further balloon and/or stent expansion in contemporary clinical practice. In the current review, we will discuss the available methods for atherectomy, including rotational, orbital, and excimer laser coronary atherectomy, as well as intravascular lithotripsy. In addition, we will review the role of imaging in calcified lesions.

Original languageEnglish (US)
JournalProgress in Cardiovascular Diseases
DOIs
StateAccepted/In press - 2021

Keywords

  • Atherectomy
  • Calcifications
  • Excimer laser
  • Intracoronary imaging
  • Intravascular lithotripsy
  • Orbital
  • Rotational

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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