Optical coherence tomography‐derived predictors of stent expansion in calcified lesions

Background Severe coronary artery calcification is associated with stent underexpansion and subsequent stent failure. Aims We aimed to identify optical coherence tomography (OCT)‐derived predictors of absolute (minimal stent area [MSA]) and relative stent expansion in calcified lesions. Methods This retrospective cohort study included patients who underwent percutaneous coronary intervention (PCI) with OCT assessment before and after stent implantation between May 2008 and April 2022. Pre‐PCI OCT was used to assess calcium burden and post‐PCI OCT was used to assess absolute and relative stent expansion. Results A total of 361 lesions in 336 patients were analyzed. Target lesion calcification (defined as OCT‐detected maximum calcium angle ≥ 30°) was present in 242 (67.0%) lesions. Following PCI, median MSA was 5.37 mm2 in calcified lesions and 6.24 mm2 in noncalcified lesions (p