IMR Press / RCM / Volume 24 / Issue 3 / DOI: 10.31083/j.rcm2403093
Open Access Review
Contribution of the Optical Coherence Tomography in Calcified Lesions
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1 Cardiology Department, Clermont-Ferrand University Hospital, CNRS, Université d’Auvergne, 63000 Clermont-Ferrand, France
2 Cardiology Department, Institut Mutualiste Montsouris, 75014 Paris, France
*Correspondence: (Géraud Souteyrand)
Rev. Cardiovasc. Med. 2023, 24(3), 93;
Submitted: 1 December 2022 | Revised: 10 February 2023 | Accepted: 13 February 2023 | Published: 20 March 2023
(This article belongs to the Special Issue Intravascular imaging and Cardiovascular intervention)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Coronary artery calcification is a complex process found predominantly in the elderly population. Coronary angiography frequently lacks sensitivity to detect, evaluate and quantify these lesions. Yet calcified lesions are considered stable, it remains associated with a higher rate of peri procedural complications during percutaneous coronary intervention (PCI) including an increased risk of stent under expansion and struts mal apposition leading to poor clinical outcome. Intracoronary imaging (Intravascular Ultra Sound (IVUS) and Optical Coherence Tomography (OCT)) allows better calcified lesions identification, localization within the coronary artery wall (superficial or deep calcifications), quantification. This lesions characterization allows a better choice of dedicated plaque-preparation tools (modified balloons, rotational or orbital atherectomy, intravascular lithotripsy) that are crucial to achieve optimal PCI results. OCT could also assess the impact of these tools on the calcified plaque morphology (plaque fracture, burring effects…). An OCT-guided tailored PCI strategy for calcified lesions still requires validation by clinical studies which are currently underway.

coronary calcification
optical coherence tomography
optical frequency domain imaging - rotational atherectomy
orbital atherectomy
intravascular lithotripsy
Fig. 1.
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