Authors
Xiaochen Liu, Mingrui Zhang, Liang Wang, Ning Wang, Tianyu Zhu, Yao Yang, Quan Yang, Wenchao Zhang, Shaoping Nie
Published in
JACC. Case reports. Pages 110648. Oct 16, 2026. Epub Oct 16, 2026.
Abstract
The study objective was to describe an optical coherence tomography (OCT)-guided strategy for stepwise calcium modification in a large protruding calcified nodule with circumferential calcium.
Rotational atherectomy was used to establish device crossability and modify superficial calcium. Serial OCT was performed to assess residual calcified nodule protrusion, circumferential calcium, lumen gain, and calcium fracture. When crossability was restored but substantial mechanical constraint persisted, the strategy was escalated to intravascular lithotripsy, followed by cutting-balloon dilation. Final OCT was used to confirm stent expansion and apposition.
Restoration of device crossability does not necessarily indicate adequate lesion preparation, whereas excessive burr escalation may increase procedural risk. Serial OCT should be used to assess the response to each modification step and guide timely strategy escalation.
OCT assessment may guide precise calcium modification and prevent stent underexpansion in complex calcified lesions.
PMID:
42886141
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.
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