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Abstract：
UNASSIGNED: Despite significant advances in treatment of coronary artery disease and improvements in interventional devices and techniques, the subset of obstructive calcified coronary artery disease remains challenging to treat. Percutaneous treatment of these lesions results in increased rates of procedural complications, as well as a higher risk of stent underexpansion and malapposition. This is associated with higher rates of restenosis, target lesion revascularization (TLR), and major adverse cardiac events (MACE). Several interventional strategies and technologies have been developed to improve lesion preparation and successful stent implantation. This includes use of cutting and scoring balloons and atherectomy devices. Several intravascular imaging techniques have also shown to have value in the treatment of complex calcified coronary lesions. These advances have improved the treatment of patients with calcified coronary disease who are often difficult to treat and frequently excluded from large randomized trials. Thoughtful, and not routine, use of rotational atherectomy can be helpful in pre-treating severely calcified lesions to achieve successful stent delivery. Orbital atherectomy represents a newer advancement in the atherectomy approach that may be beneficial in the treatment of calcified coronary disease, but further trials are needed to support its routine use.
摘要：
尽管冠状动脉疾病的治疗取得了重大进展，介入设备和技术也有所改进，梗阻性钙化性冠状动脉疾病的亚组治疗仍具有挑战性.这些病变的经皮治疗导致手术并发症的发生率增加，以及支架膨胀不足和贴壁不良的风险较高。这与更高的再狭窄率有关，靶病变血运重建(TLR),和主要不良心脏事件（MACE）。已经开发了几种介入策略和技术来改善病变准备和成功的支架植入。这包括使用切割和刻痕球囊和粥样斑块切除装置。几种血管内成像技术也显示出在复杂钙化冠状动脉病变的治疗中具有价值。这些进展改善了钙化冠心病患者的治疗，这些患者通常难以治疗，并且经常被排除在大型随机试验之外。体贴,而不是例行公事，旋磨术的使用有助于对严重钙化的病变进行预处理,从而实现成功的支架输送.眼眶动脉粥样斑块切除术代表了动脉粥样斑块切除术方法的新进展，可能有益于钙化冠状动脉疾病的治疗。但需要进一步的试验来支持其常规使用.
