ArticleFrontiers in cardiovascular medicine2026
Residual risk persists in severely calcified lesions despite optimal stent expansion: a paradoxical finding from an IVUS-guided PCI cohort.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Severe coronary artery calcification (CAC) is associated with adverse events after percutaneous coronary intervention (PCI), traditionally attributed to inadequate stent expansion. Whether severe CAC confers residual risk despite optimal acute mechanical results remains unknown. Methods: This single-center retrospective study included 709 patients who underwent pre-procedural intravascular ultrasound (IVUS) before PCI. Patients were classified as no calcification ( Results: Over a median follow-up of 18.6 months, 57 patients (8.0%) experienced TVR and 122 (17.2%) experienced MACE. Post-PCI MSA (5.9 vs. 5.6 vs. 5.8 mm Conclusion: Severe CAC identifies a subgroup at persistently elevated risk for repeat revascularization despite achieving stent expansion comparable to non-calcified lesions, challenging the conventional paradigm linking calcification to adverse events solely through underexpansion.
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