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Peer-reviewedCC BY 4.0JACC Case Reports

Slow Progression of Eruptive and Noneruptive Calcified Nodules After Atherectomy Monotherapy

  • Daiki Niizeki1
  • Masataka Nakano2
  • Tetsuya Kawamata3
  • Kota Fukushima1
  • Shinji Nakano1
  • Kotaro Miyashita2
  • Kotaro Kagiyama2
  • Nobuhiko Ogata2
  1. 1Department of Clinical Engineering, Ageo Central General Hospital, Saitama, Japan
  2. 2Department of Cardiology, Ageo Central General Hospital, Saitama, Japan
  3. 3Department of Cardiology, West Tokyo Central General Hospital, Tokyo, Japan
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Abstract

Background: Eruptive calcified nodules (CNs) are associated with poor outcomes after conventional stent- and balloon-based percutaneous coronary intervention, leaving optimal treatment strategies uncertain.

Case Summary: A 76-year-old woman presented with non–ST-segment elevation myocardial infarction. Coronary angiography and optical coherence tomography identified an eruptive CN, which was localized as the culprit lesion through functional assessment. Considering the risk of stent- and balloon-related failure, atherectomy-alone strategy, without adjunctive therapy, was performed. Serial optical coherence tomography demonstrated effective debulking with preserved vessel morphology at 5-month and 4-year follow-up without luminal compromise or recurrent events.

Discussion: Given the inherently latent pathology of eruptive CN, atherectomy monotherapy, devoid of superfluous stimuli and permanent scaffolding, may be a viable strategy for selected lesions, provided sufficient ablation was obtained.

Take-Home Message: A minimal atherectomy-alone strategy for the eruptive CN may yield maximal legacy, facilitating treatment options and straightforward lifetime management should recurrences occur.

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Cite

BibTeXRIS
BibTeX
@article{niizeki2026slow,
  title = {{Slow Progression of Eruptive and Noneruptive Calcified Nodules After Atherectomy Monotherapy}},
  author = {Daiki Niizeki and Masataka Nakano and Tetsuya Kawamata and Kota Fukushima and Shinji Nakano and Kotaro Miyashita and Kotaro Kagiyama and Nobuhiko Ogata},
  journal = {JACC Case Reports},
  year = {2026},
  month = sep,
  doi = {10.1016/j.jaccas.2026.110197},
  url = {https://doi.org/10.1016/j.jaccas.2026.110197},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Slow Progression of Eruptive and Noneruptive Calcified Nodules After Atherectomy Monotherapy
AU  - Daiki Niizeki
AU  - Masataka Nakano
AU  - Tetsuya Kawamata
AU  - Kota Fukushima
AU  - Shinji Nakano
AU  - Kotaro Miyashita
AU  - Kotaro Kagiyama
AU  - Nobuhiko Ogata
PY  - 2026
DA  - 2026/09/11
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.110197
UR  - https://doi.org/10.1016/j.jaccas.2026.110197
AB  - Background: Eruptive calcified nodules (CNs) are associated with poor outcomes after conventional stent- and balloon-based percutaneous coronary intervention, leaving optimal treatment strategies uncertain.  Case Summary: A 76-year-old woman presented with non–ST-segment elevation myocardial infarction. Coronary angiography and optical coherence tomography identified an eruptive CN, which was localized as the culprit lesion through functional assessment. Considering the risk of stent- and balloon-related failure, atherectomy-alone strategy, without adjunctive therapy, was performed. Serial optical coherence tomography demonstrated effective debulking with preserved vessel morphology at 5-month and 4-year follow-up without luminal compromise or recurrent events.  Discussion: Given the inherently latent pathology of eruptive CN, atherectomy monotherapy, devoid of superfluous stimuli and permanent scaffolding, may be a viable strategy for selected lesions, provided sufficient ablation was obtained.  Take-Home Message: A minimal atherectomy-alone strategy for the eruptive CN may yield maximal legacy, facilitating treatment options and straightforward lifetime management should recurrences occur.
SN  - 2666-0849
ER  -