Objectives: Coronary computed tomography angiography (CCTA) is often used to assess the extent and severity of atherosclerosis. A major limitation of CCTA are densely calcified coronary plaques that obscure the underlying lumen rendering assessment difficult. The purpose of this study was to evaluate the hemodynamic importance of densely calcified coronary lesions on CCTA in patients with low-to-intermediate likelihood of coronary artery disease.
Methods: We studied 92 patients (64±10 years, 75% men) who underwent CCTA and stress perfusion cardiovascular magnetic resonance (CMR). Coronary stenoses were categorized as none, less than 50%, 50-70%, and greater than 70%, or densely calcified. Coronary arteries were considered densely calcified if the artery had a calcified lesion obscuring the underlying lumen and did not have another stenosis of greater than 50%. CMR was considered abnormal if there was reversible ischemia or myocardial scar determined by the presence of late gadolinium enhancement.
Results: Among the 92 patients, 271 vessels were analyzed of which 44 (16%) were considered densely calcified. Among these 44 coronary territories, six (14%) had abnormal CMR findings. On a per-vessel analysis, a proportional increase in the number of myocardial segments with reversible ischemia or the presence of late gadolinium enhancement was associated with an increase of CCTA stenosis ranging from 2% in patients without coronary plaque to 70% in patients with a greater than 70% stenosis (P<0.0001).
Conclusion: In conclusion, the vast majority (86%) of densely calcified lesions were not hemodynamically significant in our study. As our study was in patients with relatively low-to-intermediate likelihood of coronary artery disease, a prospective study is warranted to assess if our findings are generalizable to other patient populations.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/MCA.0b013e32834a37e1 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Rare Case of Linear Phlebolith: Foreign Body Discovered in the Femoral Vein.
Case Rep Surg
January 2025
Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia.
Phlebolith is a term that refers to round-shaped calcified thrombi commonly located in the pelvic region. The occurrence of dense, linear calcifications or phlebolith-like formations within the soft tissues of the lower extremities, particularly in the superficial femoral, greater saphenous, or popliteal veins, is rare. This study presents the case of a 73-year-old woman who was being evaluated for postmenopausal bleeding.
View Article and Find Full Text PDFUltrasonic emulsification and aspiration for coral reef atherosclerosis as a novel alternative to transaortic endarterectomy and thoracic aorta-based bypass grafting.
J Vasc Surg Cases Innov Tech
April 2025
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH.
Transaortic endarterectomy (TE) is an effective and durable method of restoring patency in the aorta afflicted with atherosclerotic disease, which most commonly affects the infrarenal aorta and common iliac artery. When the suprarenal aorta is involved, the disease is usually confined to the orifices of the visceral vessels without obstruction of the aortic lumen. In rare cases, dense, calcified, exophytic, and amorphous lesions causing severe luminal obstruction, termed coral reef atherosclerosis (CRA) of the suprarenal aorta, may occur.
View Article and Find Full Text PDFResolving the bone - optimizing decalcification in spatial transcriptomics and molecular pathology.
J Histotechnol
December 2024
Department of Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Bone tissue poses critical roadblocks for spatial transcriptomics and molecular pathology due to a combination of its dense, calcified matrix and inadequate preservation of biomolecules in conventional decalcification. Decalcification is a complex and nuanced histological process to concomitantly preserve nucleic acids, proteins, and tissue architecture, ensuring molecular integrity for downstream assays. However, commonly used agents like formic and hydrochloric acids, while efficient, can degrade biomolecules to varying extents, complicating assays such as PCR, sequencing, immunohistochemistry, and hybridization.
View Article and Find Full Text PDFRhinolith Within a Giant Concha Bullosa: A Case Report and Review of Literature.
Ear Nose Throat J
December 2024
Department of Otorhinolaryngology, Al Mouwasat University Hospital, Damascus University, Damascus, Syria.
Concha bullosa is a common anatomical variation involving pneumatization of the middle turbinate. Although usually asymptomatic, a large concha bullosa can obstruct nasal airflow and cause related symptoms. Rhinoliths, calcified formations typically found in the inferior meatus, rarely appear within concha bullosa.
View Article and Find Full Text PDFAlveolar Echinococcosis - Diagnostic challenges of a parasitic disease on the rise in Europe - a case report.
Z Gastroenterol
January 2025
Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig, Germany.
Article Synopsis
- A 45-year-old man exhibited symptoms of jaundice, abdominal pain, and weight loss, leading to the diagnosis of Caroli syndrome through imaging.
- Subsequent MRI suggested the presence of a mass and bile duct stenosis that raised concerns for cholangiocarcinoma, but serology indicated an echinococcus infection instead.
- The patient ultimately underwent liver surgery, which confirmed the diagnosis of alveolar echinococcosis, emphasizing the challenges in diagnosing this neglected disease, especially in rising incidence areas like Germany.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!