Contemporary Evidence-Based Diagnosis and Management of Severe Coronary Artery Calcification

Ata Doost, James Rankin, James Sapontis, Brian Ko, Sidney Lo, Biyanka Jaltotage, Girish Dwivedi, David Wood, Jonathan Byrne, Janarthanan Sathananthan, Abdul Rahman Ihdayhid

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)


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 on the non-invasive and invasive evaluation of coronary calcification, discuss calcium modification techniques and propose an algorithm for the management of calcified coronary lesions.

Original languageEnglish
Pages (from-to)766-778
Number of pages13
JournalHeart Lung and Circulation
Issue number6
Publication statusPublished - Jun 2022


Dive into the research topics of 'Contemporary Evidence-Based Diagnosis and Management of Severe Coronary Artery Calcification'. Together they form a unique fingerprint.

Cite this