Interventions
OCT Calcium Score
OCT-based “rule of 5”. A score of 4 identifies calcified lesions at high risk of stent underexpansion that need calcium modification before stenting.
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Maximum calcium arc
Additional criteria
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Total score
0
Lower underexpansion risk
Stent expansion usually adequate with balloon preparation
Decision guide
Low risk of stent underexpansion: standard predilatation with compliant or non-compliant balloons. Cutting/scoring balloons are reasonable for focal calcium.
1 section is still unanswered — counted as 0 points.
Ranges: 0–3 Lower underexpansion risk4 High underexpansion risk
References
- Fujino A, et al. A new optical coherence tomography-based calcium scoring system to predict stent underexpansion. EuroIntervention 2018;13:e2182-e2189.
- Riley RF, et al. SCAI expert consensus statement on the management of calcified coronary lesions. J Soc Cardiovasc Angiogr Interv 2024;3:101259.
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