Percutaneous coronary intervention calcified lesions

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Overview

PCI Approaches:

CAD Revascularization:

Heart Team Approach to Revascularization Decisions
Left Main Coronary Artery Disease
Intervention in left main coronary artery disease
Non-Left Main Coronary Artery Disease
Revascularization to Improve Symptoms
Dual Antiplatelet Therapy Compliance and Stent Thrombosis
Hybrid Coronary Revascularization

Pre-procedural Considerations:

Contrast-Induced Acute Kidney Injury
Anaphylactoid Reactions
Statin Treatment
Bleeding Risk
Role of Onsite Surgical Backup

Procedural Considerations:

Vascular Access
PCI in Specific Clinical Situations:
Asymptomatic Ischemia or CCS Class I or II Angina
CCS Class III Angina
Unstable Angina/Non–ST-Elevation Myocardial Infarction
ST-Elevation Myocardial Infarction:
General and Specific Considerations
Coronary Angiography Strategies in STEMI
Primary PCI of the Infarct Artery
Delayed or Elective PCI in patients with STEMI
Fibrinolytic-Ineligible Patients
Facilitated PCI
Rescue PCI
After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion
Cardiogenic Shock
Prior Coronary Bypass Surgery
Revascularization Before Non-cardiac Surgery
Adjunctive Diagnostic Devices:
Fractional Flow Reserve
Intravascular Ultrasound
Adjunctive Therapeutic Devices:
Coronary Atherectomy
Thrombectomy
Laser Angioplasty
Cutting Balloon Angioplasty
Embolic Protection Devices
Percutaneous Hemodynamic Support Devices
Antiplatelet therapy:
Oral Antiplatelet Therapy
Glycoprotein IIb/IIIa Receptor Antagonists
Intravenous Antiplatelet therapy:
STEMI
UA/NSTEMI
SIHD
Anticoagulant Therapy:
Parenteral Anticoagulants During PCI
Unfractionated Heparin
Enoxaparin
Bivalirudin and Argatroban
Fondaparinux
No-Reflow Pharmacological Therapies
PCI in Specific Anatomic Situations:
Chronic Total Occlusions
Saphenous Vein Grafts
Bifurcation Lesions
Aorto-Ostial Stenoses
Calcified Lesions
PCI in Specific Patient Populations:
Chronic Kidney Disease
Peri-procedural Myocardial Infarction Assessment
Vascular Closure Devices

Post-Procedural Considerations:

Post-procedural Antiplatelet Therapy
Proton Pump Inhibitors and Antiplatelet Therapy
Clopidogrel Genetic Testing
Platelet Function Testing
Restenosis
Exercise Testing
Cardiac Rehabilitation

Quality and Performance Considerations:

Quality and Performance
Certification and Maintenance of Certification
Operator and Institutional Competency and Volume

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (DO NOT EDIT)[1]

Calcified Lesions (DO NOT EDIT)[1]

Class IIa
"1. Rotational atherectomy is reasonable for fibrotic or heavily calcified lesions that might not be crossed by a balloon catheter or adequately dilated before stent implantation.[2][3][4] (Level of Evidence: C) "

References

  1. ↑ 1.0 1.1 Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text "PDF" ignored (help); Unknown parameter |month= ignored (help)
  2. ↑ Moussa I, Di Mario C, Moses J, Reimers B, Di Francesco L, Martini G, Tobis J, Colombo A (1997). "Coronary stenting after rotational atherectomy in calcified and complex lesions. Angiographic and clinical follow-up results". Circulation. 96 (1): 128–36. PMID 9236427. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  3. ↑ Vaquerizo B, Serra A, Miranda F, Triano JL, Sierra G, Delgado G, Puentes A, Mojal S, Brugera J (2010). "Aggressive plaque modification with rotational atherectomy and/or cutting balloon before drug-eluting stent implantation for the treatment of calcified coronary lesions". Journal of Interventional Cardiology. 23 (3): 240–8. doi:10.1111/j.1540-8183.2010.00547.x. PMID 20636844. Retrieved 2011-12-15. Unknown parameter |month= ignored (help)
  4. ↑ Brogan WC, Popma JJ, Pichard AD, Satler LF, Kent KM, Mintz GS, Leon MB (1993). "Rotational coronary atherectomy after unsuccessful coronary balloon angioplasty". The American Journal of Cardiology. 71 (10): 794–8. PMID 8456756. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)

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