SCAI Expert Consensus Statement Addresses Management of Calcified Coronary Lesions Requiring Intervention

February 5, 2024—The Society for Cardiovascular Angiography & Interventions (SCAI) recently announced the publication of the “SCAI Expert Consensus Statement on the Management of Calcified Coronary Lesions.”

According to the society, the statement outlines methods for interventional cardiologists to identify various types of calcified coronary lesions and presents an algorithm to help them guide the use of these various calcium modification strategies.

The document by Robert F. Riley, MD, et al is available online in JSCAI. Binita Shah, MD, served as Chair of the document’s writing committee.

SCAI noted that coronary artery calcification is increasing in prevalence, leading to greater risks both during procedures such as percutaneous coronary intervention (PCI) and adverse events in the short and long term. Along with these challenges, treatment options are expanding, increasingly including calcium modification before stent implantation.

“This expert consensus statement incorporates detailed tips for the use of each treatment modality and the latest in emerging trials and therapies to help interventional cardiologists rise to these challenges,” commented SCAI President George D. Dangas, MD, in the society’s press release.

Dr. Shah stated, “The document provides images using two different types of intravascular imaging technology and a consensus of practical tips when using the different treatment strategies, including in the use of different types of calcified lesion subsets. We bring the data and our experience all together with an algorithm designed to identify and address the various calcified CAD phenotypes. Our group is proud of this document and the uniqueness of it.” Dr. Shah is Associate Professor of Medicine at NYU School of Medicine and Associate Director of Interventional Cardiology for VA NY Harbor Healthcare System in New York, New York.

As outlined by SCAI, highlights of the consensus document include:

• Calcified coronary lesions are becoming commonplace in the cardiac catheterization lab, and their treatment is associated with increased short- and long-term risks compared to noncalcified lesions.
• The use of intravascular imaging and the proper use of calcium modification devices can help decrease these risks.
• An algorithm is proposed for how to identify and treat these lesions with the various currently available calcium modification devices, along with tips and tricks for using these devices.

Dr. Riley, MD, who is Director of the Complex Coronary Therapeutics program at Overlake Medical Center & Clinics in Bellevue, Washington, stated in the SCAI press release, “This consensus statement is meant to increase awareness about the prevalence of calcified coronary lesions, the ramifications of testing these lesions when indicated, the various treatment options available including tips for using them, and offer an algorithm for choosing between these treatment options.”

Mitul Patel, MD, an interventional cardiologist at VA San Diego Health System in San Diego, California, added, “Our hope is that this document aids in improving outcomes for some of our most challenging patients.”