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Andò et al. Vessel Plus 2023;7:15 Vessel Plus
DOI: 10.20517/2574-1209.2023.26

Review Open Access

Severely calcified coronary artery lesions: focus on

interventional management

1,#
Giuseppe Andò 1,# , Giulia Alagna , Salvatore De Rosa 2,# , Francesco Pelliccia 3,# , Felice Gragnano 4,# ,
6,#
5,#
7,#
4,#
Giampaolo Niccoli , Raffaele Piccolo , Elisabetta Moscarella , Enrico Fabris , Rocco Antonio
7,#
6,#
9,#
2,#
Montone 8,# , Saverio Muscoli , Carmen Spaccarotella , Gianfranco Sinagra , Ciro Indolfi , Italo
6,#
Porto 10,# , Pasquale Perrone Filardi , Paolo Calabrò 4,#
1
Dipartimento di Medicina Clinica e Sperimentale, University of Messina, Messina 98124, Italy.
2
Dipartimento di Scienze Mediche e Chirurgiche, University of Catanzaro “Magna Graecia”, Catanzaro 88100, Italy.
3
Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, University of Rome “La Sapienza”, Rome
00185, Italy.
4
Dipartimento di Scienze Mediche Traslazionali, University of Campania “Luigi Vanvitelli”, Caserta 00186, Italy.
5
Dipartimento di Medicina e Chirurgia, University of Parma, Parma 43126, Italy.
6
Dipartimento di Scienze Biomediche Avanzate, University of Naples “Federico II”, Naples 80138, Italy.
7
Dipartimento di Scienze Mediche, Chirurgiche e della Salute, University of Trieste, Trieste 34128, Italy.
8
Istituto di Cardiologia, Catholic University of the Sacred Heart, Rome 00168, Italy.
9
Dipartimento di Medicina dei Sistemi, University of Rome “Tor Vergata”, Rome 00133, Italy.
10
DIpartimento di Medicina Interna e Specialità Mediche, University of Genoa, Genoa 16132, Italy.
#
On behalf of the Working Group of Interventional Cardiology of the Italian Society of Cardiology.
Correspondence to: Prof. Giuseppe Andò, Department of Clinical and Experimental Medicine, University of Messina, AOU
Policlinico “Gaetano Martino”, Via Consolare Valeria, Messina 98124, Italy. E-mail: giuseppeando1975@gmail.com
How to cite this article: Andò G, Alagna G, De Rosa S, Pelliccia F, Gragnano F, Niccoli G, Piccolo R, Moscarella E, Fabris E,
Montone RA, Muscoli S, Spaccarotella C, Sinagra G, Indolfi C, Porto I, Perrone Filardi P, Calabrò P. Severely calcified coronary
artery lesions: focus on interventional management. Vessel Plus 2023;7:15. https://dx.doi.org/10.20517/2574-1209.2023.26
Received: 5 May 2023 First Decision: 11 Jul 2023 Revised: 15 Jul 2023 Accepted: 21 Jul 2023 Published: 26 Jul 2023
Academic Editor: Frank W. Sellke Copy Editor: Fangling Lan Production Editor: Fangling Lan
Abstract
Severe coronary artery calcifications remain a challenge for the contemporary interventional cardiologist in the
light of the growing demand for diagnostic procedures and interventions in elderly patients; in addition, the general
prognostic improvement after percutaneous coronary intervention (PCI) is expanding the indications to PCI to
increasingly complex anatomies. In the last decade, a renewed interest in the treatment of calcific lesions has been
observed, with the aim to optimize the mechanic effects of balloon angioplasty and the expansion and apposition of
DES to the vessel wall. However, patients with calcific coronary artery disease represent a subset with a high risk of
adverse outcomes, both intra-procedural and in the long-term. The need to guarantee a targeted and tailored
treatment based on the coronary anatomy of any individual patient is a current priority of the interventional

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