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Percutaneous Coronary Intervention (PCI): Past, Present and Future
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Percutaneous Coronary Intervention (PCI): Past, Present and Future

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 4212

Special Issue Editors

Prof. Dr. Giuseppe Gargiulo

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Guest Editor
Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy
Interests: percutaneous coronary intervention; coronary artery disease; peripheral artery disease; antithrombotic therapy
Dr. Mario Enrico Canonico

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Guest Editor
1. Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
2. CPC Clinical Research, Department of Medicine, University of Colorado, Aurora, CO 80045, USA
Interests: clinical cardiology; heart failure; coronary artery disease; antithrombotic therapy; peripheral arterial disease
Dr. Marisa Avvedimento

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Guest Editor
1. Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
2. Quebec Heart and Lung Institute, Laval University, Quebec City, QC G1V0A6, Canada
Interests: transcatheter aortic valve replacement; transcatheter aortic valve implantation; percutaneous coronary intervention; coronary artery disease; antithrombotic therapy

Special Issue Information

Dear Colleagues,

Percutaneous coronary intervention (PCI) represents the most common strategy to manage flow-limiting coronary artery stenoses. According to the latest evidence from large randomized or observational studies, PCI continues to improve with an ever-broadening indication in light of the newer devices and procedural techniques, which has led higher rates of successful procedures and improved clinical outcomes over time. PCI has also been offered to more complex patients including those at high-risk or with cardiogenic shock, eventually through devices for mechanical support. Hence, a PCI strategy guided by physiology, imaging, and optimal lesion management should be pursued to obtain complete revascularization and sustained long-term results. In addition, the refinement of antithrombotic therapy in patients undergoing PCI has contributed to further improving patient outcomes; however, its optimization remains a matter of ongoing debate in order to balance ischemic and bleeding risks.

The aim of the present Special Issue is to offer insights into the implementation of diagnosis and treatment of patients with coronary artery disease (CAD), covering several aspects of interventional cardiology from procedural techniques to peri-procedural management. The intended primary target audience consists of clinicians who are involved in the care of patients for whom revascularization is indicated. The Editors hope that this Special Issue will be of interest to interventional cardiologists as well as a broader range of clinicians that encounter CAD. Therefore, we invite researchers and clinicians to submit their works, including original clinical research studies, meta-analyses, and reviews, related to the PCI field.

Prof. Dr. Giuseppe Gargiulo
Dr. Mario Enrico Canonico
Dr. Marisa Avvedimento
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • coronary revascularization
  • percutaneous coronary intervention (PCI)
  • coronary artery disease
  • acute coronary syndrome
  • chronic coronary syndrome
  • antithrombotic therapy

Published Papers (2 papers)

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Review

22 pages, 5904 KiB  
Review
Current Management of In-Stent Restenosis
by Daniele Giacoppo, Placido Maria Mazzone and Davide Capodanno
J. Clin. Med. 2024, 13(8), 2377; https://doi.org/10.3390/jcm13082377 - 19 Apr 2024
Viewed by 585
Abstract
In-stent restenosis (ISR) remains the primary cause of target lesion failure following percutaneous coronary intervention (PCI), resulting in 10-year incidences of target lesion revascularization at a rate of approximately 20%. The treatment of ISR is challenging due to its inherent propensity for recurrence [...] Read more.
In-stent restenosis (ISR) remains the primary cause of target lesion failure following percutaneous coronary intervention (PCI), resulting in 10-year incidences of target lesion revascularization at a rate of approximately 20%. The treatment of ISR is challenging due to its inherent propensity for recurrence and varying susceptibility to available strategies, influenced by a complex interplay between clinical and lesion-specific conditions. Given the multiple mechanisms contributing to the development of ISR, proper identification of the underlying substrate, especially by using intravascular imaging, becomes pivotal as it can indicate distinct therapeutic requirements. Among standalone treatments, drug-coated balloon (DCB) angioplasty and drug-eluting stent (DES) implantation have been the most effective. The main advantage of a DCB-based approach is the avoidance of an additional metallic layer, which may otherwise enhance neointimal hyperplasia, provide the substratum for developing neoatherosclerosis, and expose the patient to a persistently higher risk of coronary ischemic events. On the other hand, target vessel scaffolding by DES implantation confers relevant mechanical advantages over DCB angioplasty, generally resulting in larger luminal gain, while drug elution from the stent surface ensures the inhibition of neointimal hyperplasia. Nevertheless, repeat stenting with DES also implies an additional permanent metallic layer that may reiterate and promote the mechanisms leading to ISR. Against this background, the selection of either DCB or DES on a patient- and lesion-specific basis as well as the implementation of adjuvant treatments, including cutting/scoring balloons, intravascular lithotripsy, and rotational atherectomy, hold the potential to improve the effectiveness of ISR treatment over time. In this review, we comprehensively assessed the available evidence from randomized trials to define contemporary interventional treatment of ISR and provide insights for future directions. Full article
(This article belongs to the Special Issue Percutaneous Coronary Intervention (PCI): Past, Present and Future)
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15 pages, 809 KiB  
Review
Antithrombotic Therapy Optimization in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention
by Felice Gragnano, Antonio Capolongo, Antonio Micari, Francesco Costa, Victoria Garcia-Ruiz, Vincenzo De Sio, Fabrizia Terracciano, Arturo Cesaro, Elisabetta Moscarella, Silvio Coletta, Pasquale Raucci, Fabio Fimiani, Leonardo De Luca, Giuseppe Gargiulo, Giuseppe Andò and Paolo Calabrò
J. Clin. Med. 2024, 13(1), 98; https://doi.org/10.3390/jcm13010098 - 23 Dec 2023
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Abstract
The antithrombotic management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) poses numerous challenges. Triple antithrombotic therapy (TAT), which combines dual antiplatelet therapy (DAPT) with oral anticoagulation (OAC), provides anti-ischemic protection but increases the risk of bleeding. Therefore, TAT is [...] Read more.
The antithrombotic management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) poses numerous challenges. Triple antithrombotic therapy (TAT), which combines dual antiplatelet therapy (DAPT) with oral anticoagulation (OAC), provides anti-ischemic protection but increases the risk of bleeding. Therefore, TAT is generally limited to a short phase (1 week) after PCI, followed by aspirin withdrawal and continuation of 6–12 months of dual antithrombotic therapy (DAT), comprising OAC plus clopidogrel, followed by OAC alone. This pharmacological approach has been shown to mitigate bleeding risk while preserving adequate anti-ischemic efficacy. However, the decision-making process remains complex in elderly patients and those with co-morbidities, significantly influencing ischemic and bleeding risk. In this review, we discuss the available evidence in this area from randomized clinical trials and meta-analyses for post-procedural antithrombotic therapies in patients with non-valvular AF undergoing PCI. Full article
(This article belongs to the Special Issue Percutaneous Coronary Intervention (PCI): Past, Present and Future)
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