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BÀI TỔNG QUAN Issue: Số 123 - 2026 TIM MẠCH CAN THIỆP

Percutaneous Coronary Intervention of Calcified Coronary Lesions: A 2026 Evidence Update and Clinical Experience in Vietnam

Published: October 30, 2026
Views: 7
DOI 10.58354/jvc.123.2026.1399

Abstract

Coronary artery calcification makes percutaneous coronary intervention (PCI) more difficult: device delivery is impaired, stent underexpansion is common, and long-term outcomes are worse. This narrative review summarizes evidence published up to 2026, with emphasis on randomized trials, expert consensus documents and meta-analyses, and reports clinical experience with rotational atherectomy at the Vietnam National Heart Institute. Current data support intravascular imaging-guided assessment, device selection based on calcium morphology, and confirmation of adequate lesion preparation before stenting. Intravascular ultrasound and optical coherence tomography provide complementary information on calcium arc, length, thickness and nodular morphology. In ECLIPSE, routine orbital atherectomy offered no benefit in lesions suitable for either strategy, whereas CALIPSO and BALI supported OCT-guided lesion preparation and intravascular lithotripsy, respectively. In an initial single-centre series of 35 patients (36 lesions) treated with rotational atherectomy, procedural success was 97.2%, with no perforation or burr entrapment and no major adverse cardiac events at 3 months; transient bradycardia and hypotension were the most frequent periprocedural events. Most reported benefits of calcium modification devices remain procedural or imaging-based, and data on mortality and myocardial infarction are limited. Open questions include standardized criteria for adequate lesion preparation, tailored device combinations and long-term clinical outcomes.

Keywords
coronary calcification percutaneous coronary intervention intravascular ultrasound optical coherence tomography rotational atherectomy intravascular lithotripsy

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Tác giả

Nguyễn Ngọc Quang: Hệ thống Y tế Vinmec; Nguyễn Hữu Tuấn: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Phạm Nhật Minh: Trường Đại học Y Hà Nội; Lê Văn Đạt: Viện Tim mạch, Bệnh viện 19-8, Bộ Công an; Phan Đình Nghĩa: Viện Tim mạch, Bệnh viện 19-8, Bộ Công an; Phạm Mạnh Hùng: Trường Đại học Y Hà Nội;
Percutaneous Coronary Intervention of Calcified Coronary Lesions: A 2026 Evidence Update and Clinical Experience in Vietnam

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Section BÀI TỔNG QUAN
Issue Số 123 - 2026
Category TIM MẠCH CAN THIỆP
Pages 46-73
Copyright Holder 2026 Tạp chí Tim mạch học Việt Nam

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