{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:43:18Z","timestamp":1793418198523,"version":"4.5.0"},"reference-count":102,"publisher":"Oxford University Press (OUP)","issue":"41","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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\u2019 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.<\/jats:p>","DOI":"10.1093\/eurheartj\/ehad342","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T21:48:00Z","timestamp":1684532880000},"page":"4340-4356","source":"Crossref","is-referenced-by-count":166,"title":["Management strategies for heavily calcified coronary stenoses: an EAPCI clinical consensus statement in collaboration with the EURO4C-PCR group"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0050-5178","authenticated-orcid":false,"given":"Emanuele","family":"Barbato","sequence":"first","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sapienza University , Via di Grottarossa n. 1035, Rome, 00189 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,","place":["Italy"]},{"name":"Department of Biomedical and Clinical Sciences, University of Milan, Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2479-8144","authenticated-orcid":false,"given":"Didier","family":"Carri\u00e9","sequence":"additional","affiliation":[{"name":"Service de Cardiologie B, CHU Rangueil, Universit\u00e9 Paul Sabatier , Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4461-2055","authenticated-orcid":false,"given":"Carlo","family":"Di Mario","sequence":"additional","affiliation":[{"name":"Interventional Structural Cardiology Division, Department of Clinical & Experimental Medicine, Careggi University Hospital , Florence ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dariusz","family":"Dudek","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Jagiellonian 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