Coronary disease & ACSCohort study
A Revised Optical Coherence Tomography–Derived Calcium Score to Predict Stent Underexpansion in Severely Calcified Lesions
- Retrospective observational study
- derivation and validation cohorts
Authors' conclusion
This revised OCT-derived calcium score can serve as a reliable tool for identifying severely calcified lesions at risk for stent underexpansion.
Study context
- Population
- De novo severely calcified lesions (optical coherence tomography (OCT) maximum superficial calcium angle >270°, angiographically visible calcium) undergoing OCT-guided stenting, without atherectomy or specialty balloon before stenting
- Participants
- 250 lesions
- Exposure
- Derivation vs Validation
- Derivationn = 167
- Validationn = 83
- Outcome
- Stent expansion (minimum stent area/average reference luminal area) at the maximum calcium site; underexpansion = expansion <70%
Main finding
As reported in the abstract
Stent expansion
- Calcium >270° with length >3 mm · derivation cohort, multivariable linear regression
- regression coefficient −10.3 (95% CI −17.8 to −2.8); P = 0.007
- Calcium angle of 360° · derivation cohort, multivariable linear regression
- regression coefficient −15.5 (95% CI −25.2 to −5.8); P = 0.002
- Minimum calcium thickness >0.30 mm · derivation cohort, multivariable linear regression
- regression coefficient −12.4 (95% CI −19.1 to −5.6); P = 0.0004
- Calcium score (range 0-3) · validation cohort
- regression coefficient −9.1 (95% CI −12.6 to −6.1); P < 0.0001
- Stent underexpansion (all lesions)
- 19.6% (49 of 250)
Observational data: associations, not effects.
Original publication
A Revised Optical Coherence Tomography–Derived Calcium Score to Predict Stent Underexpansion in Severely Calcified Lesions. JACC Cardiovasc Interv. Published 10 March 2025. doi:10.1016/j.jcin.2024.12.001
Summarised from the published abstract; every number is checked against it