Why the study?
Coronary arterial calcification impedes safe and predictable PCI, and although guidelines recommend calcium modification across several available techniques, the most optimal technique remains unclear.
Do specific lesion preparation or stenting techniques reduce all-cause mortality or serious adverse events in patients undergoing PCI for moderately or severely calcified coronary lesions?
Population
8,453 participants in 31 randomised trials undergoing PCI for moderately or severely calcified coronary lesions
Comparison
Lesion preparation or stenting/scaffold techniques vs alternative PCI strategies
Design
Systematic review with meta-analysis and trial sequential analysis of randomised trials
Key result
Among 8,453 participants, various lesion preparation and stenting techniques showed no significant differences in all-cause mortality or serious adverse events for calcified coronary lesions.
Authors
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Equipoise persists among calcium modification strategies in calcified PCI; larger trials needed to detect hard-endpoint differences.
Meta-Analysis (n=8,453)
Do specific lesion preparation or stenting techniques reduce all-cause mortality or serious adverse events in patients undergoing PCI for moderately or severely calcified coronary lesions?
Current randomized evidence shows no significant differences in mortality or serious adverse events among various calcium modification and stenting techniques for calcified coronary lesions, highlighting clinical equipoise and the need for adequately powered trials.
Kristensen et al. (2025) conducted a meta-analysis in Moderately or severely calcified coronary lesions (n=8,453). Lesion preparation and stenting techniques vs. Alternative lesion preparation or stenting techniques was evaluated on All-cause mortality and serious adverse events. Among 8,453 participants, various lesion preparation and stenting techniques showed no significant differences in all-cause mortality or serious adverse events for calcified coronary lesions.
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