Methods for treating coronary eruptive calcified nodules

Catheter Cardiovasc Interv. 2024 Nov;104(5):899-906. doi: 10.1002/ccd.31226. Epub 2024 Sep 19.

Abstract

Eruptive calcified nodules (CNs) are a manifestation of severely calcified plaques, which exist in acute coronary syndrome (ACS), non-ACS lesions. Optical coherence tomography is crucial for diagnosing and treating eruptive CNs in clinical practice. Management of eruptive CNs is still a challenge for interventional cardiologists. There have been significant advances in the treatment of eruptive CNs such as intravascular lithotripsy, excimer laser coronary atherectomy, rotational atherectomy, and orbital atherectomy. We find a range of treatment modalities to be effective under different conditions. The selection of these devices should be considered based on guidewire position, lesion characteristics, clinical manifestations, and operator's experiences.

Keywords: eruptive calcified nodule; excimer laser coronary atherectomy; intravascular lithotripsy; orbital atherectomy; rotational atherectomy.

MeSH terms

  • Atherectomy, Coronary* / instrumentation
  • Atherectomy, Coronary* / methods
  • Coronary Angiography
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • Humans
  • Lithotripsy* / instrumentation
  • Lithotripsy* / methods
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Plaque, Atherosclerotic* / therapy
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Calcification* / diagnostic imaging
  • Vascular Calcification* / therapy