Calcified coronary nodules: pathophysiology, diagnosis, and interventional challenges

Calcified coronary nodules (CCNs) represent a distinct and under-recognized form of coronary artery calcification with significant implications for percutaneous coronary intervention (PCI). Unlike superficial or sheet-like calcifications, CCNs are characterized by protruding, irregular calcium deposits that disrupt luminal integrity, promote thrombus formation, and hinder optimal stent expansion. They have been implicated in acute coronary syndromes (ACS), in-stent restenosis (ISR), and PCI fail