OCT and Calcium—You Cannot Treat What You Cannot See

In this issue of JAMA Cardiology, Amabile et al report the results of the Calcified Lesion Intervention Planning Steered by OCT (CALIPSO) randomized clinical trial comparing optical coherence tomography (OCT) vs angiography when guiding percutaneous coronary intervention (PCI) procedures for calcified lesions. The investigators demonstrated that OCT combined with a calcium management algorithm improved the minimal stent area (MSA) compared with angiography (median [IQR], 6.5 [5.5-1.1] vs 5.0 [4.1-6.1] mm2; P < .001) without increasing periprocedural complications, contrast volume, or procedural time.