Calcium modification techniques in complex percutaneous coronary intervention: State-of-the-art review.

As patients increase in age and medical complexity, coronary artery calcification is frequently encountered and its presence portends worse outcomes following percutaneous coronary intervention (PCI) - negatively impacting procedural success and long-term outcomes. This review paper explores available imaging techniques and calcium modification technique that can identify, characterize and modify these lesions to facilitate stent implantation. The data supporting these techniques are explored and an algorithm for decision-making during lesion modification is presented. Current barriers and future directions are additionally discussed.