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Current Trends and Future Challenges in Percutaneous Coronary Intervention
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Current Trends and Future Challenges in Percutaneous Coronary Intervention

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

Deadline for manuscript submissions: closed (20 February 2026) | Viewed by 5511

Editor

Dr. Deniz Mutlu

E-Mail Website
Guest Editor
Minneapolis Heart Institute, Minneapolis, MN, USA
Interests: complex coronary PCI; PCI; bifurcation; bifurcation PCI; chronic total occlusion; CTO; mechanical circulatory support; data science

Special Issue Information

Dear Colleagues,

The field of percutaneous coronary intervention (PCI) continues to evolve rapidly, driven by advances in imaging technologies, device innovations, and procedural techniques. Contemporary PCI strategies now offer enhanced precision in lesion assessment and stent deployment, significantly improving patient outcomes. Developments such as intravascular imaging (IVUS, OCT), physiology-guided PCI, and the use of drug-coated balloons are expanding the boundaries of what is achievable in coronary intervention.

Additionally, the treatment of complex coronary lesions—such as chronic total occlusions, bifurcation lesions, and left main disease—has become increasingly feasible, supported by dedicated tools and techniques. The integration of artificial intelligence and robotic-assisted PCI is also beginning to shape the future landscape of interventional cardiology.

Despite these advances, several challenges remain. These include addressing long-term outcomes in high-risk populations, optimizing antithrombotic therapy to balance ischemic and bleeding risks, and improving access to PCI in resource-limited settings. Moreover, the clinical integration of novel technologies and techniques must be guided by robust evidence to ensure safety and efficacy.

In this Special Issue, we invite authors to contribute original research and review articles on the latest clinical advances in PCI, focusing on innovations, unresolved questions, and future directions in the diagnosis and interventional treatment of coronary artery disease.

Dr. Deniz Mutlu
Guest Editor

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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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

  • PCI
  • IVUS
  • OCT
  • FFR
  • physiology
  • CT-guided PCI
  • complex PCI
  • CTO
  • bifurcation
  • coronary complications
  • mechanical circulatory support

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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10 pages, 595 KB  
Article
Electrical Risk Score as a Predictor of Coronary Artery Disease
by Özge Turgay Yıldırım, Tuğba Dişikırık, Gamze Yeter Arslan, Mehmet Semih Belpınar, Ayberk Beral, Barış Özden and Mehmet Özgeyik
J. Clin. Med. 2025, 14(22), 8106; https://doi.org/10.3390/jcm14228106 - 16 Nov 2025
Cited by 1 | Viewed by 962
Abstract
Background/Objectives: Coronary artery disease (CAD) is a leading cause of global mortality, necessitating effective risk stratification tools for optimal patient management. The electrical risk score (ERS) is a multi-parametric index incorporating various electrocardiographic (ECG) parameters, previously shown to predict unfavorable cardiovascular outcomes. However, [...] Read more.
Background/Objectives: Coronary artery disease (CAD) is a leading cause of global mortality, necessitating effective risk stratification tools for optimal patient management. The electrical risk score (ERS) is a multi-parametric index incorporating various electrocardiographic (ECG) parameters, previously shown to predict unfavorable cardiovascular outcomes. However, the relationship between ERS and the presence and severity of CAD remains unclear. This study aimed to investigate the association of ERS with the presence and extent of CAD as assessed by coronary angiography. Methods: This retrospective study included 314 consecutive patients who underwent coronary angiography. ERS was calculated using six ECG parameters: heart rate > 75 bpm, left ventricular hypertrophy, delayed QRS transition zone, frontal QRS-T angle > 90°, prolonged QTc interval, and extended T peak to T end interval. Results: Of the study population (mean age 57.8 ± 11.4, 61.5% male), 158 were diagnosed with CAD, and 156 constituted the control group. The mean ERS was significantly higher in the CAD group than the control group (2.34 ± 1.35 vs. 1.78 ± 1.12, p = 0.006). Among ERS components, delayed QRS transition (p = 0.023), prolonged QTc (p = 0.004), and extended T peak to T end interval (p = 0.001) were notably more prevalent in the CAD group. ERS was independently associated with the presence of CAD on multivariate logistic regression analysis (p < 0.05). Conclusions: ERS is significantly associated with the presence and severity of CAD in stable patients. Elevated ERS, particularly due to delayed QRS transition, prolonged QTc, and extended T peak to T end interval, may serve as a valuable, non-invasive marker for prediction and early identification of CAD. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Percutaneous Coronary Intervention)
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13 pages, 487 KB  
Article
The Impact of Cangrelor in the UK for the Treatment of STEMI Patients with Gastric Absorption Issues Undergoing Percutaneous Coronary Intervention
by Bhavik Modi, Rob Cain, Richard Stork, Gina Tarpey, Alessia Colucciello, Danielle Olivier, Caroline Barwood, Will Wright and Rory McAtamney
J. Clin. Med. 2025, 14(21), 7564; https://doi.org/10.3390/jcm14217564 - 25 Oct 2025
Viewed by 1078
Abstract
Background/Objectives: Patients that undergo percutaneous coronary intervention (PCI) require effective antiplatelet therapies to minimize the risk of thrombotic cardiovascular events. Oral P2Y12 inhibitors are often utilized, however co-administered opioids may lead to gastric absorption issues in these patients, affecting the efficacy of [...] Read more.
Background/Objectives: Patients that undergo percutaneous coronary intervention (PCI) require effective antiplatelet therapies to minimize the risk of thrombotic cardiovascular events. Oral P2Y12 inhibitors are often utilized, however co-administered opioids may lead to gastric absorption issues in these patients, affecting the efficacy of oral inhibitors. Cangrelor is an intravenous, direct-acting, reversible P2Y12 inhibitor that could be explored as a potential treatment option for patients with gastric absorption issues during ST-elevation myocardial infarction. The objective was to estimate the UK budget impact of introducing cangrelor for ST-elevation myocardial infarction (STEMI) patients with gastric absorption issues undergoing PCI. Methods: A budget impact model was developed to calculate the impact of introducing cangrelor to treat STEMI patients with gastric absorption issues undergoing PCI, to the UK National Health Service and personal social services, over 5 years. Oral P2Y12 inhibitors (clopidogrel, prasugrel, and ticagrelor), glycoprotein IIb/IIIa inhibitors (eptifibatide and tirofiban), and aspirin and heparin alone were included as base case comparators. Cangrelor uptake ranged from 10% to 30% in years 1–5. The cangrelor-eligible population was estimated at 10,903 patients per year. Results: Over 5 years, cangrelor leads to a small cost saving (0.29%), varying from −GBP 261,989 in year 1 to GBP 174,778 in year 5. The introduction of cangrelor is estimated to lead to 314 fewer hospital days and 190 clinical events avoided over 5 years. Conclusions: Introducing cangrelor to STEMI patients with gastric absorption issues undergoing PCI in the UK is estimated to generate a small cost saving and reduced length of stay for some patients. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Percutaneous Coronary Intervention)
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Review

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19 pages, 1537 KB  
Review
No-Reflow During Coronary Interventions: A Narrative Review
by Sara Malakouti, Ahmed Hashim, Marco Frazzetto and Bernardo Cortese
J. Clin. Med. 2025, 14(22), 7976; https://doi.org/10.3390/jcm14227976 - 11 Nov 2025
Cited by 10 | Viewed by 2971
Abstract
The coronary no-reflow phenomenon remains a daunting and unresolved barrier during percutaneous coronary procedures, especially for acute coronary syndrome. Despite successful epicardial artery patency restoration, decreased microvascular perfusion leads to unfavorable outcomes such as ventricular remodeling, progression of heart failure, and increased mortality. [...] Read more.
The coronary no-reflow phenomenon remains a daunting and unresolved barrier during percutaneous coronary procedures, especially for acute coronary syndrome. Despite successful epicardial artery patency restoration, decreased microvascular perfusion leads to unfavorable outcomes such as ventricular remodeling, progression of heart failure, and increased mortality. This review provides a new, integrative informative perspective by combining multifactorial pathophysiology, which includes systemic inflammation, thrombogenicity, ischemia–reperfusion injury, and distal embolization, with advances in diagnostic imaging, such as cardiac magnetic resonance and computed tomography. Therapeutic options, including antithrombotic regimes, vasodilators, and mechanical adjuncts, are evaluated in the context of developing debates and unmet clinical needs. Importantly, we provide feasible future directions for artificial intelligence-based predictive modeling and targeted microvascular treatments. This comprehensive review fills a significant gap, aiming to inform personalized approaches and improve both short- and long-term outcomes in this high-risk patient population. Full article
(This article belongs to the Special Issue Current Trends and Future Challenges in Percutaneous Coronary Intervention)
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