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Advances and Future Directions in Percutaneous Coronary Intervention (PCI)

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

Deadline for manuscript submissions: 31 October 2025 | Viewed by 1034

Special Issue Editors


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Guest Editor
Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico “Rodolico—San Marco”, Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
Interests: interventional cardiology; percutaneous coronary interventions; coronary artery disease; acute myocardial infarction; intravascular imaging; coronary physiology; cardiovascular pharmacology; chronic total occlusion; bifurcation disease; transcatheter aortic valve implantation; edge-to-edge mitral valve repair; patent foramen ovale closure; left atrial appendage closure; peripheral artery disease; endovascular interventions for chronic limb ischemia; carotid artery stenting
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Guest Editor
Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico “Rodolico—San Marco”, Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
Interests: acute coronary syndromes; anticoagulant therapy; antiplatelet therapy; antithrombotic therapy; cardiovascular pharmacology; cardiovascular prevention; chronic coronary syndromes; coronary artery disease; high bleeding risk; high thrombotic risk; interventional cardiology; interventional pharmacology; lipid-lowering drugs; lipid metabolism; percutaneous coronary interventions; risk stratification; thrombosis

Special Issue Information

Dear Colleagues,

We are excited to serve as the Guest Editors for a Special Issue of the Journal of Clinical Medicine dedicated to current progress and future directions in interventional cardiology to be published in May 2025. This Special Issue, titled “Advances and Future Directions in Percutaneous Coronary Interventions (PCI)”, will focus on current advances in coronary artery disease and intervention.

In recent years, there has been significant progress in the field of interventional cardiology from novel devices (including thin-strut second-generation drug-eluting stents, sirolimus-coated balloons, new-generation bioresorbable scaffolds, and bioadaptors) to appealing antithrombotic strategies (e.g., P2Y12 inhibitor monotherapy in place of aspirin, very short dual antiplatelet therapy, dual antiplatelet therapy P2Y12 inhibitor de-escalation, and aspirin-free antithrombotic therapy after percutaneous coronary intervention). In addition, a substantial amount of new evidence on intravascular imaging techniques (i.e., intravascular ultrasound and optical coherence tomography) for guiding and optimizing percutaneous coronary interventions has strengthened recommendations and raised new questions. Similarly, multiple recent trials on percutaneous coronary intervention in patients with acute myocardial infarction and multivessel disease have enhanced our undestanding on the prognostic value of myocardial revascularization completeness, timing, and guidance. Finally, emerging angiography-based techniques to assess coronary physiology (quantitative flow ratio, non-invasive index of microvascular resistance, etc.) open new diagnostic opportunities. The goal of this Special Issue is to update the practicing interventional cardiologist and provide a comprehensive collection of review articles.

To this end, we would like to invite state-of-the-art reviews focusing on advances in percutaneous coronary interventions, including the evolution of interventional techniques, new devices for percutaneous coronary intervention, and medical therapy (i.e., antithrombotic therapy in coronary artery disease).

The deadline for the submission of these articles to the journal is 31 May 2025. We look forward to your submissions.

Dr. Daniele Giacoppo
Dr. Antonio Greco
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.

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Keywords

  • drug-eluting stents
  • drug-coated balloons
  • bioresorbable vascular scaffolds
  • antiplatelet therapy
  • intravascular ultrasound
  • optical coherence tomography
  • quantitative flow ratio
  • complete revascularization

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Published Papers (2 papers)

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Research

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14 pages, 1052 KiB  
Article
Role of Femoral Artery Access Characteristics and Female Sex in In-Hospital Complications for Patients Undergoing Recanalization of Chronic Total Occlusions
by Kevin Hamzaraj, Caglayan Demirel, Antonia Domanig, Senta Graf, Mariann Gyöngyösi, Christian Hengstenberg, Bernhard Frey and Rayyan Hemetsberger
J. Clin. Med. 2025, 14(13), 4496; https://doi.org/10.3390/jcm14134496 - 25 Jun 2025
Viewed by 447
Abstract
Background: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remains a complex procedure that requires advanced operator skills and dedicated devices. Despite increased success rates in experienced centers, the in-hospital complications of CTO PCI remain notably high. Female patients undergoing CTO PCI [...] Read more.
Background: Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) remains a complex procedure that requires advanced operator skills and dedicated devices. Despite increased success rates in experienced centers, the in-hospital complications of CTO PCI remain notably high. Female patients undergoing CTO PCI are reported to experience higher rates of complications; however, the underlying mechanisms remain inadequately defined. Methods: We prospectively enrolled consecutive patients undergoing CTO PCI at our university-affiliated tertiary care center over 4 years (2018–2021), aiming to elucidate sex-based disparities in in-hospital complications. In addition, we investigated the impact of angiographic femoral artery metrics on in-hospital complications. Results: Among 271 patients who underwent antegrade or retrograde CTO PCI, 222 (81.9%) were men and 49 (18.9%) women. Female patients were significantly older (67 ± 11 vs. 72 ± 12 years; p = 0.005) and had a comparable lesion complexity. Women exhibited smaller femoral artery diameters, more side branches at the puncture area and higher bifurcations. In-hospital complications occurred more frequently in women compared to men (16.3% vs. 6.8%; p = 0.044). Female sex independently predicted in-hospital complications (OR = 2.92; CI 1.07 to 7.60; p = 0.024), yet lost significance after adjustment for femoral artery characteristics. Maximal femoral artery diameter (OR = 0.30, 95% CI: 0.17 to 0.50, p < 0.001) and side-branch density (OR = 2.45, 95% CI: 1.26 to 5.20, p = 0.012) independently predicted in-hospital complications. Conclusions: Female patients undergoing CTO PCI are at increased risk for procedural complications, likely driven by femoral artery anatomical differences. Detailed pre-procedural assessment of femoral artery metrics may improve patient selection, procedural planning, and outcomes, particularly among women. Full article
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Review

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32 pages, 2377 KiB  
Review
Antiplatelet Monotherapies for Long-Term Secondary Prevention Following Percutaneous Coronary Intervention
by Claudio Laudani, Daniele Giacoppo, Antonio Greco, Luis Ortega-Paz, Georges El Khoury, Davide Capodanno and Dominick J. Angiolillo
J. Clin. Med. 2025, 14(15), 5536; https://doi.org/10.3390/jcm14155536 - 6 Aug 2025
Viewed by 194
Abstract
In patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), antiplatelet therapy is the cornerstone of treatment for secondary prevention. Although dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 inhibitor is the current standard of care, being, respectively, [...] Read more.
In patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI), antiplatelet therapy is the cornerstone of treatment for secondary prevention. Although dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 inhibitor is the current standard of care, being, respectively, recommended for 6 and 12 months in patients with chronic and acute coronary syndrome without a need for oral anticoagulation, the continuous improvement in PCI technology and pharmacology have significantly reduced the need for long-term DAPT. Mounting evidence supports the administration of P2Y12 inhibitor monotherapy, particularly ticagrelor, after a short period of DAPT following PCI as a strategy to reduce bleeding without a trade-off in ischemic events compared to standard DAPT. In addition, there is a growing literature supporting P2Y12 inhibitor monotherapy also for long-term secondary prevention of ischemic events. However, the data to this extent are not as robust as compared to the first-year post-PCI period, with aspirin monotherapy still remaining the mainstay of treatment for most patients. This review aims to summarize the rationale for long-term antiplatelet therapy, the pharmacology of current antiplatelet drugs tested for long-term administration as monotherapy, and current evidence on the available comparisons between different long-term antiplatelet monotherapies in patients with CAD. Full article
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