A review of the pathogenic mechanism and clinical management progress of in-stent calcification restenosis - Scorecard - MDSpire

A review of the pathogenic mechanism and clinical management progress of in-stent calcification restenosis

  • By

  • Xiangchen Xia

  • Fei Luo

  • Jianchun Li

  • Quanyi Liu

  • Jianzhong Pang

  • Fuyun Jia

  • Qiang Xu

  • Chao Peng

  • May 29, 2026

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Clinical Scorecard: An Overview of the Pathophysiology and Advances in the Management of In-Stent Restenosis Due to Calcification

At a Glance

CategoryDetail
Condition
Key MechanismsCalcification impairs stent expansion and exacerbates neointimal hyperplasia.
Target PopulationPatients undergoing coronary PCI with calcified lesions.
Care Setting

Key Highlights

  • Calcified lesions restrict stent expansion and increase ISR risk.
  • High-resolution imaging (OCT/IVUS) aids in evaluating calcification characteristics.
  • Novel therapies like intravascular lithotripsy and orbital atherectomy improve management of calcific ISR.
  • Conventional treatments face limitations in severe calcification cases.

Guideline-Based Recommendations

Diagnosis

  • Utilize high-resolution intravascular imaging (OCT/IVUS) for evaluation of calcification.

Management

  • Consider novel therapies such as intravascular lithotripsy and hybrid ablation strategies for calcific ISR.

Monitoring & Follow-up

  • Monitor for restenosis risk based on calcification characteristics.

Risks

  • Calcification can lead to stent underexpansion and malapposition.

Patient & Prescribing Data

Patients with coronary artery disease undergoing PCI with calcified lesions.

Novel technologies enhance procedural safety and lumen gain in calcified ISR.

Clinical Best Practices

  • Employ high-pressure non-compliant balloon angioplasty with caution in calcified lesions.
  • Utilize drug-coated balloons judiciously, considering impaired drug transfer in calcified settings.
  • Incorporate imaging techniques to guide treatment decisions.

Related Resources & Content

Original Source(s)

A review of the pathogenic mechanism and clinical management progress of in-stent calcification restenosis

  • by Xiangchen Xia, Fei Luo, Jianchun Li, Quanyi Liu, Jianzhong Pang, Fuyun Jia, Qiang Xu, Chao Peng

  • May 29, 2026

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