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Clinical Management Strategies for Coronary Artery Disease and Revascularization

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Dr. Marco Spagnolo

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Guest Editor

Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico “G. Rodolico—San Marco”, University of Catania, 95123 Catania, Italy
Interests: coronary artery disease; percutaneous coronary intervention; coronary artery bypass grafting; coronary physiology; coronary imaging; antithrombotic therapy

Special Issue Information

Dear Colleagues,

I am excited to serve as Guest Editor for a Special Issue of the Journal of Clinical Medicine dedicated to current progress and future directions in coronary artery disease, titled “Clinical Management Strategies for Coronary Artery Disease and Revascularization.”

Coronary artery disease has been consistently recognized for decades as the leading cause of mortality worldwide. In recent years, substantial progress has been made—from the early identification and study of angiographically non-obstructive plaques at risk of progression or destabilization, to the pharmacological treatment of these lesions and the emerging potential for interventional approaches. At the same time, major advances in invasive and non-invasive coronary physiology and imaging have refined our understanding of obstructive plaque characteristics and the functional significance of stenoses. These developments, together with innovations in device technologies and increasingly personalized antiplatelet therapies, have significantly influenced strategies for revascularization (percutaneous coronary intervention and coronary artery bypass grafting) and ultimately improved the clinical outcomes of these procedures.

The goal of this Special Issue is to provide practicing clinical and interventional cardiologists and cardiac surgeons with a comprehensive collection of state-of-the-art review articles and original research on the management of coronary artery disease.

Topics will span invasive and non-invasive coronary physiology, invasive and non-invasive plaque imaging, strategies for percutaneous and surgical revascularization, novel devices for coronary revascularization, and emerging antithrombotic approaches for primary and secondary prevention of coronary artery disease.

The deadline for manuscript submission is 25 July 2026. We look forward to receiving your contributions.

Dr. Marco Spagnolo
Guest Editor

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10 pages, 437 KB

Open AccessArticle

Revascularization of Left Anterior Descending Artery with Minimally Invasive Direct Coronary Artery Bypass Graft vs. Drug Eluting Stents: A Retrospective, Two-Center Study

by Amit Gordon, Yaron Moshkovitz, Dmitry Pevni, Orr Sela, Nadav Teich, Mohammad Kakoush, Tomer Ziv-Baran and Yanai Ben-Gal

J. Clin. Med. 2026, 15(5), 1863; https://doi.org/10.3390/jcm15051863 - 28 Feb 2026

Viewed by 290

Abstract

Background/Objectives: Revascularization of the left anterior descending (LAD) artery can be achieved by either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Minimally invasive direct CABG (MIDCAB) enables LAD revascularization via a small thoracotomy without sternotomy or cardiopulmonary bypass. To compare long-term survival following LAD revascularization by MIDCAB or following PCI using drug-eluting stents (DES), of the historic cohort we reported in 2006. Methods: Data were assessed of 272 patients who underwent LAD PCI with DES, and 104 patients who underwent MIDCAB using the left internal thoracic artery (LITA) to LAD, in two major centers, between May 2002 and December 2003. Matching for age, sex, and extent of coronary disease yielded two balanced groups of 83 patients each. Results: Baseline characteristics were similar with a mean age ± standardized difference (SD) of 64.70 ± 12.52 of the MIDCAB group vs. 63.59 ± 12.06 of the Cypher group and an identical male to female ratio of 66 to 83 (79.5%), except for a higher prevalence of EF < 35% in the MIDCAB group and prior PCI in the DES group. Thirty-day mortality was 1.1% after MIDCAB and 0% after DES-PCI (p = 0.11). At 2 years, the proportion of recurrent angina was lower after MIDCAB (8.4% vs. 35%; p < 0.001), as was the proportion of re-interventions (3.6% vs. 16.8%; p = 0.005). Over a mean follow-up of 16 years, 10-year survival was 77.1 ± 4.6% for the MIDCAB and 81.0 ± 4.3% for the DES group (p = 0.48). The rates of 20-year survival were 60.2 ± 5.4% and 56.1 ± 5.5%, respectively (p = 0.73). In multivariable analysis, advanced age and prior myocardial infarction independently predicted mortality while treatment with MIDCAB showed a trend toward improved survival (p = 0.053). Conclusions: Long-term survival rates after LAD revascularization with MIDCAB and after DES-PCI were comparable. MIDCAB demonstrated a non-significant trend toward lower mortality. Limitations include the retrospective design and lack of detailed late event adjudication. Full article

(This article belongs to the Special Issue Clinical Management Strategies for Coronary Artery Disease and Revascularization)

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