Optimizing Percutaneous Coronary Intervention in Calcified Lesions Insights From Optical Coherence Tomography of Atherectomy

Optimal coronary stent implantation is among the few successful strategies in preventing stent failures, notably in-stent restenosis and stent thrombosis. 1 Understanding the intravascular milieu is a prerequisite for optimization of percutaneous coronary intervention (PCI). Calcified lesions limit stent expansion, the most robust predictor of target lesion revascularization, and are thus associated with worst outcomes. 2 Coronary angiography is a poor discriminator of calcium distribution and thickness. Reliance on angiography to guide PCI and define procedural success in severe coronary calcification is associated with poor outcomes. 3 Both intravascular ultrasound and optical coherence tomography (OCT) enable detailed evaluation of cross-sectional ...