Abdirashid Mohamed, Barbero Umberto, Cavallino Chiara, Maltese Ludovica, Bacci Elodi, Reale Danilo, Marengo Giorgio, De Benedictis Michele, Rametta Francesco, Ugo Fabrizio
Sant'Andrea Hospital, 13100 Vercelli, Italy.
Santissima Annunziata Hospital, 12038 Savigliano, Italy.
J Cardiovasc Dev Dis. 2024 Jul 15;11(7):224. doi: 10.3390/jcdd11070224.
Coronary artery calcification is a complex anatomical and histological pathology with different pathways that contribute to calcium deposit and calcification progression. As part of the atherosclerotic process, extensive calcifications are becoming more common and are associated with poorer PCI outcomes if not properly addressed. Since no drug has shown to be effective in changing this process once it is started, proper knowledge of the underlying pathogenesis and how to diagnose and manage it is essential in contemporary coronary intervention. Atherosclerosis is a pandemic disease, quickly spreading across the world and not limited anymore to the industrialized Western world. In this paper, we review the role of intracoronary imaging and the main technologies available and propose a simple and rational algorithm for the choice of a preferential first strategy in the treatment of severely calcified coronary atherosclerosis, followed by three emblematic cases on how we successively applied it.
冠状动脉钙化是一种复杂的解剖学和组织病理学病变，有不同的途径导致钙沉积和钙化进展。作为动脉粥样硬化过程的一部分，广泛的钙化越来越常见，如果处理不当，会导致经皮冠状动脉介入治疗（PCI）的预后较差。由于一旦这个过程开始，没有药物被证明能有效改变它，因此，了解其潜在的发病机制以及如何诊断和管理它，对于当代冠状动脉介入治疗至关重要。动脉粥样硬化是一种大流行病，正在迅速蔓延至全球，不再局限于西方工业化国家。在本文中，我们回顾了冠状动脉内成像的作用和现有的主要技术，并提出了一种简单合理的算法，用于选择治疗严重钙化冠状动脉粥样硬化的优先初始策略，随后通过三个典型病例说明我们是如何相继应用该算法的。
