Percutaneous coronary interventions in calcified coronary lesions: imaging, tools, and outcomes

Developments in the use of intracoronary imaging, with particular emphasis on the detection and evaluation/quantification of calcium, combined with an expanding armamentarium of adjunctive tools to modify calcific lesions offer exciting times for the interventional cardiologist. Most importantly, it provides hope for patients with complex coronary disease that they can return to normal life with lesser risk of future events or need for repeat revascularization. Debate regarding algorithms of treatment will continue and instead we would urge the interventional community to adopt a new philosophy of interventional treatment. Delineating the disease that we are treating, ensuring effective preparation and device selection, before utilizing an image-guided approach to optimization will ensure the best results for our patients in the future.