Discrepancy Between Optical Coherence Tomography-Based and Intravascular Ultrasound-Based Calcium Scoring for Heavily Calcified Coronary Lesions.

Background: Intravascular lithotripsy (IVL) is currently recommended for heavily calcified coronary lesions with an optical coherence tomography (OCT)- or intravascular ultrasound (IVUS)-based calcium score of 3 or 4.

Results: We retrospectively assessed both calcium scores for the same lesions, which had a heavily calcified coronary lesion requiring plaque modification. Among 52 lesions, the mean OCT-based calcium score was 3.96, whereas the mean IVUS-based calcium score was 2.15 (P<0.001).

Conclusions: This comparative study revealed a significant discrepancy between IVUS- and OCT-based calcium scores in heavily calcified coronary lesions, which may influence treatment strategies, including use of IVL.