The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Editorial

Severely calcified coronary stenoses: a war or a battle?

EuroIntervention 2021;17:445-446. DOI: 10.4244/EIJV17I6A80

1. Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium; 2. Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy
For interventional cardiologists, management of heavily calcified stenosis represents a common challenge in daily practice, beginning with the diagnostic evaluation of the extension and severity of the calcium burden. On coronary angiography, operators systematically underestimate calcified lesions1. Careful independent core lab evaluation estimates this rate to be around 30-40%2. However, it is only with intravascular imaging that the diagnostic accuracy of calcium detection goes up to 80%3. The practical consequence of this limited diagnostic ability of coronary angiography is that heavily calcified lesions are often diagnosed too late, e.g., in case of a suboptimal balloon dilatation or, in the worst ...

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