Patients with severely calcified coronary lesions undergoing percutaneous revascularization have a substantial risk of adverse outcomes, both during the procedure and in the long term. Over the last decade, a renewed interest has been observed about devices for plaque modification and lesion preparation, new technologies have been introduced in clinical practice and well-known devices have undergone technical and procedural improvements. The available tools for intravascular imaging allow a detailed evaluation of the calcific plaques within all the layers of the vessel wall. The complementary use of all these tools is ultimately aimed at optimizing the mechanics of balloon angioplasty and the delivery and expansion of drug-eluting stents. It has been fully demonstrated that rotational atherectomy improves procedural success when treating heavily calcified lesions. Intravascular lithotripsy, techniques and materials used during complex procedures such as chronic total occlusions, increasing operators' experience, as well as new drug-eluting stents with excellent mechanical characteristics, have further contributed to the feasibility and the safety of treating most fibrotic and heavily calcified vessels. We finally propose an algorithm for evaluation and treatment of severely calcific coronary lesions to demonstrate how such percutaneous revascularization procedures are planned and performed.

Evaluation and percutaneous treatment of severely calcified coronary lesions / Ando, G.; Vizzari, G.; Niccoli, G.; Calabro, P.; Zimarino, M.; Spaccarotella, C.; De Rosa, S.; Piccolo, R.; Gragnano, F.; Mancone, M.; Muscoli, S.; Romeo, F.; Indolfi, C.. - In: GIORNALE ITALIANO DI CARDIOLOGIA. - ISSN 1827-6806. - 22:6(2021), pp. 480-489. [10.1714/3612.35932]

Evaluation and percutaneous treatment of severely calcified coronary lesions

Spaccarotella C.;Piccolo R.;Indolfi C.
2021

Abstract

Patients with severely calcified coronary lesions undergoing percutaneous revascularization have a substantial risk of adverse outcomes, both during the procedure and in the long term. Over the last decade, a renewed interest has been observed about devices for plaque modification and lesion preparation, new technologies have been introduced in clinical practice and well-known devices have undergone technical and procedural improvements. The available tools for intravascular imaging allow a detailed evaluation of the calcific plaques within all the layers of the vessel wall. The complementary use of all these tools is ultimately aimed at optimizing the mechanics of balloon angioplasty and the delivery and expansion of drug-eluting stents. It has been fully demonstrated that rotational atherectomy improves procedural success when treating heavily calcified lesions. Intravascular lithotripsy, techniques and materials used during complex procedures such as chronic total occlusions, increasing operators' experience, as well as new drug-eluting stents with excellent mechanical characteristics, have further contributed to the feasibility and the safety of treating most fibrotic and heavily calcified vessels. We finally propose an algorithm for evaluation and treatment of severely calcific coronary lesions to demonstrate how such percutaneous revascularization procedures are planned and performed.
2021
Evaluation and percutaneous treatment of severely calcified coronary lesions / Ando, G.; Vizzari, G.; Niccoli, G.; Calabro, P.; Zimarino, M.; Spaccarotella, C.; De Rosa, S.; Piccolo, R.; Gragnano, F.; Mancone, M.; Muscoli, S.; Romeo, F.; Indolfi, C.. - In: GIORNALE ITALIANO DI CARDIOLOGIA. - ISSN 1827-6806. - 22:6(2021), pp. 480-489. [10.1714/3612.35932]
File in questo prodotto:
File Dimensione Formato  
Valutazione e trattamento interventistico delle lesioni coronariche severamente calcifiche.pdf

non disponibili

Tipologia: Versione Editoriale (PDF)
Licenza: Accesso privato/ristretto
Dimensione 2.49 MB
Formato Adobe PDF
2.49 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/879158
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 2
  • ???jsp.display-item.citation.isi??? 2
social impact