Patterns of Calcification in Coronary Artery Disease

Mintz, Gary S.; Popma, Jeffrey J.; Pichard, Augusto D.; Kent, Kenneth M.; Satler, Lowell F.; Chuang, Ya Chien; Ditrano, Christine J.; Leon, Martin B.

doi:10.1161/01.cir.91.7.1959

Cited by 544 publications

(157 citation statements)

References 41 publications

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“…Of 1155 coronary native vessel target lesions studied (1117 subjects), calcification was seen in 38% of all lesions via angiogram and 73% via IVUS [19]. These findings suggest that coronary calcification is not only relatively common, but also may be underrepresented by angiography alone.…”

Section: Coronary Arterial Calcification Is Underappreciatedmentioning

confidence: 90%

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Chambers

Diage

2014

Expert Review of Medical Devices

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Section: Coronary Arterial Calcification Is Underappreciatedmentioning

confidence: 90%

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Chambers

Diage

2014

Expert Review of Medical Devices

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“…On the contrary, angiography will sometimes reveal severe calcification in the coronary arteries, while IVUS will show primarily deep calcification and very little superficial calcification. Mintz, et al 15) reported IVUS findings from 1,155 diseased lesions. Angiography showed calcification in 38% of the lesions, while IVUS detected calcification in 73%, of which 28% were deep calcification only.…”

Section: Discussionmentioning

confidence: 99%

Initial and Long-Term Outcomes of Sirolimus-Eluting Stents for Calcified Lesions Compared With Bare-Metal Stents

et al. 2007

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SUMMARYThe aim of this study was to compare the initial and long-term outcomes of sirolimuseluting stents (SES) and bare-metal stents (BMS) in patients with calcified lesions without performing rotational atherectomy.The subjects were 79 consecutive lesions (38 in the SES group and 41 in the BMS group) which were confirmed to have superficially calcified lesions by intravascular ultrasound. In all lesions, the stent was implanted after predilatation with a balloon.The patient characteristics were not different between the 2 groups. All procedures were successfully performed in both groups. Vessel area was significantly smaller in the SES group than in the BMS group (11.01 ± 3.88 mm 2 versus 13.08 ± 3.49 mm 2 , P < 0.005), as was the lumen area (5.41 ± 2.31mm 2 versus 6.48 ± 2.04 mm 2 , P < 0.005). Minimum stent area was significantly smaller in the SES group than in the BMS group (5.61 ± 1.54 mm 2 versus 6.69 ± 1.74 mm 2 , P < 0.01). In cases in whom angiographic follow-ups were performed, the late loss was significantly smaller in the SES group than in the BMS group (0.19 ± 0.49 mm versus 0.76 ± 0.48 mm, P < 0.001). The restenosis rate was significantly lower in the SES group than in the BMS group (8.8% versus 33.3%, P < 0.05) and the TLR rate tended to be lower in the SES group (7.9% versus 19.5%). Stent thrombosis was not observed in either group.The results suggest that SES are more effective than BMS and can be used safely when treating calcified lesions if predilatation with a balloon is possible. (Int Heart J 2007; 48: 137-147)

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“…We expected that changes in treatment and outcome might attenuate the correlation of some previously important lesion characteristics with outcome. We intended to make use of inferences from observations with the use of intracoronary ultrasound and angioscopy [17][18][19] to postulate new or modified angiographic characteristics to evaluate. We recognized, however, that prediction of risk generally becomes more difficult as overall risk diminishes (as it has in the decade since the modified ACC/AHA scheme was developed).…”

Section: Discussionmentioning

confidence: 99%

Relation Between Lesion Characteristics and Risk With Percutaneous Intervention in the Stent and Glycoprotein IIb/IIIa Era

et al. 1999

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Background-The currently used American College of Cardiology/American Heart Association lesion classification scheme dates from an era when balloon angioplasty was the only percutaneous treatment available and major complications occurred in Ϸ7% of patients. Major advances in treatment options would suggest that this scheme may be outmoded, but the schemes that have been suggested to update lesion classification have not been widely accepted. Methods and Results-Four thousand one hundred eighty-one consecutive patients (6676 lesions) formed a training set and 2146 patients (4231 lesions) formed a validation set treated from 1995 to 1997 at a single center used by 3 hospital groups. Twenty-seven pretreatment candidate variables were analyzed with the use of stepwise proportional logistic regression, and 9 (nonchronic total occlusion with TIMI flow 0, degenerated vein graft, vein graft age Ͼ10 years, lesion length Ն10 mm, severe calcium, lesion irregularity, large filling defect, angulated Ն45 degrees plus calcium, and eccentricity) were independently correlated (PϽ0.05) with ranked adverse outcome (death, Q-wave or creatine kinase Ն3ϫ normal myocardial infarction, or emergency coronary artery bypass graftingϾ Ͼcreatine kinase 2 to 3ϫ myocardial infarctionϾ Ͼpossibly related to non-Q-wave myocardial infarctionϾ Ͼno complication). A scheme based on these findings and the old American College of Cardiology/American Heart Association scheme were found to have c-statistics in the validation set of 0.672 and 0.620 (Pϭ0.010 vs old scheme), respectively. Conclusions-Appreciation of these contemporary risk factors for complications of coronary intervention may assist in patient selection and in risk adjustment for comparison of outcomes between providers. (Circulation. 1999;100:1971-1976.)

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Patterns of Calcification in Coronary Artery Disease

Cited by 544 publications

References 41 publications

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Evaluation of the Diamondback 360 Coronary Orbital Atherectomy System for treatingde novo, severely calcified lesions

Initial and Long-Term Outcomes of Sirolimus-Eluting Stents for Calcified Lesions Compared With Bare-Metal Stents

Relation Between Lesion Characteristics and Risk With Percutaneous Intervention in the Stent and Glycoprotein IIb/IIIa Era

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