The CALIPSO trial has unveiled compelling evidence supporting the use of optical coherence tomography (OCT) in guiding percutaneous coronary intervention (PCI) for moderate to severe calcified lesions. Findings from this trial were presented by Nicolas Amabile, Université de Paris, France, today at EuroPCR.
Calcifications within coronary arteries have long posed challenges in PCI, increasing the risk of adverse outcomes such as stent restenosis, thrombosis, and the need for repeat revascularisation. While various management algorithms for calcified lesions have been proposed, data supporting these approaches have remained scarce.
The CALIPSO trial aimed to fill this crucial knowledge gap by comparing OCT-guided PCI with conventional angiography-based strategies. The prospective, multicentre, randomised trial enrolled patients with stable coronary lesions and moderate to severe calcified culprit lesions, excluding those with specific contraindications such as cardiogenic shock or acute coronary syndrome related to the target lesion.
Key findings from the CALIPSO trial have demonstrated the superiority of OCT-guidance in achieving optimal post-PCI outcomes. The OCT-guided group achieved a superior minimum stent area compared to angiography-guided PCI, meeting the primary endpoint of the trial. Additionally, OCT-guided PCI led to greater stent expansion and lower rates of malapposition, without compromising procedural safety.
While these imaging endpoints are promising, the clinical implications of OCT-guided PCI in terms of patient outcomes warrant further investigation. The CALIPSO trial sets a new standard in the management of calcified lesions, offering hope for improved PCI outcomes and enhanced patient care in the future.
Reference:
Amabile N et al. OCT vs. angiography for guidance of calcified lesions PCI: the CALIPSO (CAlcified Lesion Intervention Planning Steered by OCT) trial. EuroPCR 16.05.2024.
