Journal of Clinical Medicine

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Special Issue Editors

Dr. Carlo Briguori

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Guest Editor

Department of Cardiology, Interventional Cardiology, Mediterranea Cardiocentro, 80122 Naples, Italy
Interests: chronic kidney disease; drug eluting stent; coronary angiography; antiplatelet therapy; percutaneous coronary intervention; interventional cardiology

Prof. Dr. Giuseppe Sangiorgi

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Guest Editor

Department of Biomedicine and Prevention, University of Rome Tor Vergata, 1 viale Montpellier, 00133 Rome, Italy
Interests: drug eluting stent; coronary angiography; antiplatelet therapy; percutaneous coronary intervention; interventional cardiology

Dr. Flavio Airoldi

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Guest Editor

Cardiovascular Department, IRCCS MultiMedica Hospital, 20099 Milano, Italy
Interests: chronic kidney disease; drug eluting stent; coronary angiography; antiplatelet therapy; percutaneous coronary intervention; interventional cardiology

Special Issue Information

Dear Colleagues,

During the last few years, several ground-breaking improvements have been carried out in the fields of the diagnosis and management of coronary artery disease. Advances in the evaluation of the physiological indexes and imaging techniques have dramatically changed our ability to detect the very specific features of each coronary lesion, allowing highly targeted treatments. In the setting of percutaneous coronary interventions (PCI), new devices and techniques for the treatment of highly challenging anatomical settings have led to a significant increase in the number of patients eligible for non-surgical revascularization. Moreover, new revascularization strategies such as PCI with drug-coated balloons in “de novo” coronary lesions (without the need for stent implantation) are currently under investigation. The mutual relationship between these new advances and the patients’ outcomes following PCI is a major topic of research.

In this Special Issue entitled “Coronary Revascularization: Latest Advances and Prospects” we call for papers which aim to investigate how these new revascularization strategies can impact the outcomes of those undergoing PCI in the modern era.

Dr. Carlo Briguori
Prof. Dr. Giuseppe Sangiorgi
Dr. Flavio Airoldi
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 artery disease
acute coronary syndromes
chronic coronary syndromes
percutaneous coronary interventions
intravascular imaging
drug-coated balloon
drug-eluting stent
coronary physiology

Published Papers (2 papers)

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Review

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10 pages, 692 KiB

Open AccessReview

Severe Refractory Vasoplegic Shock Syndrome after OPCABG Successfully Treated with Hydroxycobalamin: A Case Report and Review of the Literature

by Beatrice Bacchi, Francesco Cabrucci, Bruno Chiarello, Aleksander Dokollari and Massimo Bonacchi

J. Clin. Med. 2024, 13(1), 169; https://doi.org/10.3390/jcm13010169 - 28 Dec 2023

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Abstract

Background: Vasoplegic shock syndrome (VSS) after an off-pump coronary artery bypass graft (OPCABG) is an extremely rare condition. Inotropic support is usually the first-line therapy, though it can precipitate several complications or be ineffective. We report the first case of severe refractory VSS after OPCABG successfully treated with hydroxycobalamin. Methods: A 77-year-old gentleman underwent OPCABG for three vessels coronary artery disease. Preoperative LV ejection fraction was 28%, and the patient before surgery started sacubitril/valsartan titrated, then, at the highest dose. Surgery was uneventful and, by the end of the procedure, TEE showed improved biventricular contractility. Results: The patient was transferred to the ICU without inotropic support, but soon developed hypotension. TEE ruled out pericardial tamponade and confirmed fair contractility. Norepinephrine was titrated to a medium-high dose, vasopressin was started and a Swan-Ganz catheter was placed. SVR was 480 dyn·s·cm⁻⁵. Despite aggressive pharmacologic treatment (including methylprednisolone and methylene blue), no improvements were noticed. Ten grams of hydroxycobalamin were administered. One hour later, hemodynamic status re-assessment showed SVR > 800 dyn·s·cm⁻⁵. Afterward, vasopressors were gradually reduced. Conclusions: Our case demonstrated the importance of adequate early treatment in VSS after OPCABG. This case report shows, for the first time, that hydroxycobalamin was effectively used to restore homeostasis. Full article

(This article belongs to the Special Issue Coronary Revascularization: Latest Advances and Prospects)

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Other

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12 pages, 1941 KiB

Open AccessSystematic Review

Comparison between Imaging and Physiology in Guiding Coronary Revascularization: A Meta-Analysis

by Riccardo Improta, Gianluca Di Pietro, Michele Giansanti, Francesco Bruno, Ovidio De Filippo, Marco Tocci, Riccardo Colantonio, Gennaro Sardella, Fabrizio D’Ascenzo and Massimo Mancone

J. Clin. Med. 2024, 13(9), 2504; https://doi.org/10.3390/jcm13092504 - 24 Apr 2024

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Abstract

Background: Percutaneous coronary intervention (PCI) is a widely used revascularization strategy for coronary artery disease. The choice between imaging-guided and physiology-guided PCI has been a subject of debate. This meta-analysis aims to systematically compare outcomes between imaging and physiology-guided PCI and management of intermediate coronary lesions (ICLs). Methods: A comprehensive literature search was conducted across major databases for studies published up to December 2023 following PRISMA guidelines. Seven eligible studies comparing imaging-guided and physiology-guided PCI were selected for the final analysis. Relevant outcome measures included major adverse cardiovascular events (MACE), target vessel revascularization (TVR), target vessel failure (TVF), and target lesion revascularization (TLR). Subgroup analysis was performed for ICLs. Results: A total of 5701 patients were included in the meta-analysis. After a mean follow-up of 2.1 years, imaging-guided PCI was associated with lower rates of TVR compared to physiology-guided PCI (OR 0.70, 95% CI 0.52–0.95, p = 0.02); concerning MACE, TVF, and TLR, no differences were found. When the analysis was restricted to studies considering ICLs management, there were no differences between the two techniques. Meta regression analysis did not show any impact of acute coronary syndromes (ACS) presentation on MACE and TVR. Conclusions: The findings suggest that imaging-guided PCI may reduce the need for future revascularization of the target vessel compared to the functional-guided approach, and this result was not influenced by ACS presentation. These results may have important implications for clinical practice, guiding interventional cardiologists in selecting the most appropriate guidance strategy. Full article

(This article belongs to the Special Issue Coronary Revascularization: Latest Advances and Prospects)

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