Calcified coronary nodule: Tip of the iceberg on a road full of thorns

Abstract

Key Points Nodular coronary calcium (NC) is infrequent, is associated with advanced age and chronic kidney disease and may be responsible for acute coronary syndromes. NC leads to a greater incidence of stent malapposition and target lesion revascularization, and intravascular imaging often shows recurrence of the calcified nodule within the stent. Clinical outcomes are worse after stenting lesions with calcified nodules, but randomized studies are necessary to determine the best management strategy.