About this Research Topic
Coronary artery calcification (CAC) has posed unique challenges since the advent of percutaneous coronary interventions. CAC may complicate into inability to cross device, acute stent under-expansion, and exfoliation of drug or polymer from stents causing insufficient drug delivery.
The calcified plaque deters successful stent implantation until the lesion is adequately prepared. Calcium is an independent risk factor for target lesion revascularization.
Various atherectomy tools, such as rotational atherectomy, orbital atherectomy, laser atherectomy, and cutting or scoring balloons, are used in clinical practice. They are designed to increase coronary compliance by mechanically disrupting the calcium. Recently, intravascular lithotripsy (IVL) has been approved by FDA for preparing calcified lesions. It uses shockwave therapy to fracture calcium which facilitates stent delivery and apposition. The use of IVL has increased significantly since its approval. The goal of this collection is to provide updated techniques for coronary calcium modification.
While these calcium modifying tools can be used alone or in combination, atherectomy is usually needed for uncrossable lesions. There are no clinical trials comparing different types of atherectomy and atherectomy with IVL. Moreover, drug-coated balloons are a potential option for calcified plaques. The clinical outcomes of such tools are not well described in special populations and special lesions (as outlined in the topics below). We invite you to choose from the following sub-topics.
1. The safety and efficacy of drug-coated balloon in calcified coronary plaques
2. The use of intravascular lithotripsy in peripheral and structural heart disease
3. The use of coronary intravascular lithotripsy in special populations: women, elderly, and in the context of PCI at centers without surgical back up.
4. The use of Coronary intravascular lithotripsy in special lesions: in-stent restenosis, acute coronary syndrome, adjunct therapy to atherectomy.
The calcified plaque deters successful stent implantation until the lesion is adequately prepared. Calcium is an independent risk factor for target lesion revascularization.
Various atherectomy tools, such as rotational atherectomy, orbital atherectomy, laser atherectomy, and cutting or scoring balloons, are used in clinical practice. They are designed to increase coronary compliance by mechanically disrupting the calcium. Recently, intravascular lithotripsy (IVL) has been approved by FDA for preparing calcified lesions. It uses shockwave therapy to fracture calcium which facilitates stent delivery and apposition. The use of IVL has increased significantly since its approval. The goal of this collection is to provide updated techniques for coronary calcium modification.
While these calcium modifying tools can be used alone or in combination, atherectomy is usually needed for uncrossable lesions. There are no clinical trials comparing different types of atherectomy and atherectomy with IVL. Moreover, drug-coated balloons are a potential option for calcified plaques. The clinical outcomes of such tools are not well described in special populations and special lesions (as outlined in the topics below). We invite you to choose from the following sub-topics.
1. The safety and efficacy of drug-coated balloon in calcified coronary plaques
2. The use of intravascular lithotripsy in peripheral and structural heart disease
3. The use of coronary intravascular lithotripsy in special populations: women, elderly, and in the context of PCI at centers without surgical back up.
4. The use of Coronary intravascular lithotripsy in special lesions: in-stent restenosis, acute coronary syndrome, adjunct therapy to atherectomy.
Keywords: Coronary artery calcification, calcified coronary plaques, intravascular lithotripsy, rotational atherectomy, orbital atherectomy, laser atherectomy, cutting balloons, scoring balloons
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