Choosing the right calcium strategy

Vascular calcification (VC) is defined as mineral deposition in the vasculature in the form of calcium-phosphate complexes. Although VC is regarded as part of the normal ageing process, certain pathological processes such as diabetes, hypertension, chronic kidney disease (CKD) or rare hereditary disorders may also precipitate the condition. Traditionally, calcification is classified into two forms, […]Vascular calcification (VC) is defined as mineral deposition in the vasculature in the form of calcium-phosphate complexes. Although VC is regarded as part of the normal ageing process, certain pathological processes such as diabetes, hypertension, chronic kidney disease (CKD) or rare hereditary disorders may also precipitate the condition. Traditionally, calcification is classified into two forms, depending on where the mineral is deposited. Intimal calcification is closely related to lipid deposits, and the clinically relevant infiltration of inflammatory cells, with obstructive arterial disease, whereas the latter is more pronounced by transformation into osteoblast-like cells from smooth muscle cells. Medial calcification is more prevalent in diseases including CKD, diabetes and arterial stiffness, rather than obstructions that are clinically significant in this pathology. VC has an inseparable relationship with atherosclerotic vascular disease. In addition, it is known that arterial stiffness, which represents the functional disturbance of VC, is an independent predictor of cardiovascular mortality.1 VC presents a barrier in the effective endovascular treatment of peripheral arterial disease (PAD) as it is resistant to conventional balloon angioplasty and stenting. Over the past decades several new technologies have emerged to deal with VC with promising results.

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