Impact of Coronary Calcification on PCI Success Rates: Procedural Challenges, Clinical Outcomes, and Optimization Strategies

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2024, Volume 2, Issue 2 : 1-7

Research Article

Impact of Coronary Calcification on PCI Success Rates: Procedural Challenges, Clinical Outcomes, and Optimization Strategies

Arman H. Rahman

Sophia L. Carter

Michael J. Bennett

Department of Interventional Cardiology, Global Heart Research Institute, London, United Kingdom

Division of Cardiovascular Medicine, European Clinical Research University, Berlin, Germany

Center for Coronary Intervention and Imaging, International Medical University, Singapore

Abstract

Coronary calcification is a major determinant of technical complexity and clinical outcomes during percutaneous coronary intervention (PCI). Calcified coronary lesions are associated with impaired balloon expansion, suboptimal stent delivery, inadequate stent expansion, increased procedural time, higher contrast use, and elevated risk of complications. Although contemporary PCI technologies have improved outcomes in complex coronary artery disease, severe coronary calcification remains a significant predictor of procedural failure, restenosis, stent thrombosis, and repeat revascularization. This article reviews the impact of coronary calcification on PCI success rates, focusing on mechanisms of procedural difficulty, imaging assessment, lesion preparation strategies, device-based calcium modification, and clinical outcomes. The paper proposes an Integrated Calcified Lesion PCI Optimization Framework to improve procedural success and long-term patient outcomes.

Keywords

Coronary Calcification

Percutaneous Coronary Intervention

PCI Success

Stent Expansion

Intravascular Imaging

Atherectomy

Intravascular Lithotripsy

Coronary Artery Disease

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