REVIEW ARTICLE
Interventional Cardiology
doi: 10.25005/2074-0581-2025-27-1-170-180
CORONARY ARTERY CALCIFICATION: PATHOGENESIS AND METHODS OF MYOCARDIAL REVASCULARIZATION

A.S. FYODOROV, A.N. SHISHKEVICH, V.N. KRAVCHUK, SH.M. ASADULAEV, O.YA. POREMBSKAYA, U.M. MURATBEKOVA

North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russian Federation

The review presents contemporary data on the etiology, pathogenesis, and prevalence of coronary artery calcification (CAC), a significant concern in cardiology. CAC and atherosclerosis of the coronary arteries (CA) are interconnected and may develop concurrently. Various factors contribute to CAC, including genetic predisposition, aging, and comorbidities. Local and systemic factors damage the arterial layers and facilitate the development of atherosclerotic calcium plaques, which are central to the pathogenesis of myocardial vascular calcification. CAC can be categorized into primary and secondary calcification and dystrophic, metastatic, and metabolic types. The extent of calcification is assessed using various methods that help tailor an individual management strategy for patients. Nonetheless, the intravascular diagnosis of calcification and the selection of appropriate techniques for restoring the lumen of affected vessels remain challenging. In mild cases of CAC, the balloon method may be employed, possibly alongside intravascular lithotripsy. Conversely, more severe calcification may require aggressive treatment, including ablative techniques such as rotational and orbital atherectomy. Balloon lithoplasty, due to its ease of use and effectiveness on superficial and deep calcium deposits, is an emerging technology that may take a leading role compared to other treatment methods.

This study involved an analysis of various literature sources, utilizing search engines such as PubMed, eLibrary, Medscape, and Medline, focusing on publications from the past decade. The keywords used in the search included ischemic heart disease, calcification, stenting, rotational atherectomy, coronary artery, atherosclerosis, etiology, pathogenesis, and prevalence. The methodologies adopted for this work included axiomatic method, synthesis, and abstraction.

Keywords: Coronary artery disease, calcification, coronary artery, atherosclerosis, etiology, pathogenesis, prevalence, stenting, rotational atherectomy.

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Authors' information:

Fyodorov Artyom Sergeevich,
Doctor for X-ray Endovascular Diagnostics and Treatment in the cathlab, as part of the Department of X-ray Surgical Methods of Diagnosis and Treatment of the Peter the Great Clinic, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0001-8608-3238
E-mail: Artem.Fedorov@szgmu.ru

Shishkevich Andrey Nikolaevich,
Doctor of Medical Sciences, Associate Professor of the Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0003-4605-6678
E-mail: shishkevich50@mail.ru

Kravchuk Viacheslav Nikolaevich,
Doctor of Medical Sciences, Full Professor, Head of the Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0002-6337-104X
E-mail: kravchuk9@yandex.ru

Asadulaev Shamil Magomedovich,
Doctor for X-ray Endovascular Diagnostics and Treatment in the cathlab, as part of the Department of X-ray Surgical Methods of Diagnosis and Treatment of the Peter the Great Clinic, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0002-1915-1250
E-mail: shamil.asadulaev@szgmu.ru

Porembskaya Olga Yaroslavna,
Candidate of Medical Sciences, Assistant of the Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0000-0003-3537-7409
E-mail: porembskaya@yandex.ru

Muratbekova Umut Muratbekovna,
Postgraduate Student of the Department of Cardiovascular Surgery, North-Western State Medical University named after I.I. Mechnikov
ORCID ID: 0009-0009-9854-9838
E-mail: umutmurat.kg@gmail.com

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Conflicts of interest: No conflict

Address for correspondence:

Fyodorov Artyom Sergeevich
Doctor for X-ray Endovascular Diagnostics and Treatment in the athlab, as part of the Department of X-ray Surgical Methods of Diagnosis and Treatment of the Peter the Great Clinic, North-Western State Medical University named after I.I. Mechnikov

191015, Russian Federation, St. Petersburg, Kirochnaya str., 41

Tel.: +7 (911) 1938659

E-mail: Artem.Fedorov@szgmu.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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