Combined Heart-Procedure Techniques Improve Stent Expansion in Severely Calcified Arteries

Severe calcium deposits in coronary arteries can make it difficult to expand a stent properly during angioplasty. Inadequate stent expansion can affect the result of the procedure and may increase the risk of complications.

Researchers at Mount Sinai Hospital evaluated whether combining two calcium-modification techniques could improve stent expansion. Rotational atherectomy uses a specialised device to modify hard calcium deposits, while intravascular lithotripsy uses acoustic pressure waves to fracture calcium within the artery.

The NODULE-SHOCK trial enrolled 120 patients with severely calcified coronary arteries. In the subgroup of 66 patients with calcified nodules, 33 received rotational atherectomy followed by intravascular lithotripsy, while 33 received intravascular lithotripsy alone. Optical coherence tomography was used to assess the calcium and measure the final stent expansion.

The researchers reported better stent expansion with the combined approach. The findings may help clinicians evaluate treatment strategies for complex coronary lesions. However, the study results should be considered alongside clinical outcomes, procedural risks and longer-term follow-up before changing routine practice.