Key result
Atherectomy monotherapy effectively debulks an eruptive calcified nodule with no recurrent events at 4 years.
Why the study?
Eruptive calcified nodules are associated with poor outcomes after conventional stent- and balloon-based PCI, leaving optimal treatment strategies uncertain.
Does atherectomy monotherapy preserve vessel morphology and prevent recurrent events in a patient with an eruptive calcified nodule?
Case Report (n=1)
Does atherectomy monotherapy preserve vessel morphology and prevent recurrent events in a patient with an eruptive calcified nodule?
Atherectomy monotherapy may be a viable, stent-free strategy for selected eruptive calcified nodules, demonstrating preserved vessel morphology and no recurrent events up to 4 years in this case.
May support stent-free atherectomy for selected eruptive calcified nodules; leaves open need for prospective trials before practice change.
BACKGROUND: Eruptive calcified nodules (CNs) are associated with poor outcomes after conventional stent- and balloon-based percutaneous coronary intervention, leaving optimal treatment strategies uncertain. CASE SUMMARY: A 76-year-old woman presented with non-ST-segment elevation myocardial infarction. Coronary angiography and optical coherence tomography identified an eruptive CN, which was localized as the culprit lesion through functional assessment. Considering the risk of stent- and balloon-related failure, atherectomy-alone strategy, without adjunctive therapy, was performed. Serial optical coherence tomography demonstrated effective debulking with preserved vessel morphology at 5-month and 4-year follow-up without luminal compromise or recurrent events. DISCUSSION: Given the inherently latent pathology of eruptive CN, atherectomy monotherapy, devoid of superfluous stimuli and permanent scaffolding, may be a viable strategy for selected lesions, provided sufficient ablation was obtained. TAKE-HOME MESSAGE: A minimal atherectomy-alone strategy for the eruptive CN may yield maximal legacy, facilitating treatment options and straightforward lifetime management should recurrences occur.
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Niizeki et al. (2026) conducted a case report in Non-ST-segment elevation myocardial infarction with eruptive calcified nodule (n=1). Atherectomy monotherapy was evaluated on Luminal compromise or recurrent events. Atherectomy monotherapy for an eruptive calcified nodule resulted in effective debulking with preserved vessel morphology and no recurrent events at 4-year follow-up.
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