Abstract：
Since the publication of the 2015 EAPCI consensus on rotational atherectomy, the number of percutaneous coronary interventions (PCI) performed in patients with severely calcified coronary artery disease has grown substantially. This has been prompted on one side by the clinical demand for the continuous increase in life expectancy, the sustained expansion of the primary PCI networks worldwide, and the routine performance of revascularization procedures in elderly patients; on the other side, the availability of new and dedicated technologies such as orbital atherectomy and intravascular lithotripsy, as well as the optimization of the rotational atherectomy system, has increased operators\' confidence in attempting more challenging PCI. This current EAPCI clinical consensus statement prepared in collaboration with the EURO4C-PCR group describes the comprehensive management of patients with heavily calcified coronary stenoses, starting with how to use non-invasive and invasive imaging to assess calcium burden and inform procedural planning. Objective and practical guidance is provided on the selection of the optimal interventional tool and technique based on the specific calcium morphology and anatomic location. Finally, the specific clinical implications of treating these patients are considered, including the prevention and management of complications and the importance of adequate training and education.
摘要：
自2015年EAPCI关于旋转粥样斑块切除术的共识发表以来，严重钙化冠状动脉疾病患者接受经皮冠状动脉介入治疗(PCI)的数量大幅增加.这一方面是由于临床上对预期寿命的持续增加的需求，全球主要PCI网络的持续扩展和老年患者血运重建程序的常规表现；另一方面，新的和专用技术的可用性，如眼眶旋切术和血管内碎石术，以及旋磨术系统的优化，增加了运营商尝试更具挑战性的PCI的信心。与EURO4C-PCR小组合作编写的当前EAPCI临床共识声明描述了严重钙化冠状动脉狭窄患者的综合管理。从如何使用非侵入性和侵入性成像来评估钙负荷并告知程序计划开始。根据特定的钙形态和解剖位置，为选择最佳的介入工具和技术提供了客观和实用的指导。最后,考虑了治疗这些患者的具体临床意义，包括并发症的预防和管理，以及适当培训和教育的重要性。
