Interventional Options for Coronary Artery Calcification

Coronary artery calcification is an integral process in atherogenesis. When it is moderate or severe, coronary artery calcification presents several challenges to percutaneous coronary intervention. Historically, these difficulties have caused percutaneous coronary intervention of calcified lesions to be associated with lower rates of procedural success, higher rates of angiographic complications, and higher rates of subsequent adverse cardiovascular events. With growth of technologies and maturation of technique for atheroablation, in particular rotational atherectomy and orbital atherectomy, percutaneous coronary intervention of calcified coronary lesions has become possible with an extremely high success rate and a favorable safety profile. In this focused review, we present an updated overview of the pathobiology of coronary artery calcification and discuss the current slate of options for interventional management of calcified coronary lesions.